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儿科领域的共同决策:文献综述与概念分析

Shared decision-making in the paediatric field: a literature review and concept analysis.

作者信息

Park Eun Sook, Cho In Young

机构信息

College of Nursing, Korea University, Seoul, South Korea.

Department of Nursing, Dong Kang University, Kwang-Ju, South Korea.

出版信息

Scand J Caring Sci. 2018 Jun;32(2):478-489. doi: 10.1111/scs.12496. Epub 2017 Sep 13.

Abstract

AIM

The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field.

METHOD

Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field.

RESULTS

The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care.

CONCLUSION

This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field.

摘要

目的

共同决策的概念定义不明确,且常与相关术语互换使用。本研究的目的是界定和阐明儿科领域共同决策的概念。

方法

采用罗杰斯和克纳夫的进化概念分析法来界定和阐明该概念。在检索1995年至2016年期间的CINAHL、PubMed和MEDLINE数据库以及在线期刊后,我们共纳入了42篇提及儿科领域共同决策的文章。

结果

其属性包括父母、儿童和健康专业人员三方的积极参与;合作关系;达成妥协;以及儿童健康的共同目标。前提条件是存在几种具有不同可能结果的选择;存在重大决策冲突;认识到需要就儿童健康状况进行决策;以及愿意参与决策。最后,结果包括决策冲突减少;相互赋权;儿童健康状况改善;以及儿科医疗保健质量提高。

结论

本研究提供了对儿科领域共同决策概念的理论理解;此外,将这一概念融入儿科实践可能有助于缩小理论与实践之间的差距。该分析还可为护理研究人员提供有关儿科决策的见解,并为制定未来干预措施和针对具体情况的理论奠定基础,以促进儿科领域的高质量决策。

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