Truglio-Londrigan Marie, Slyer Jason T
Pace University, College of Health Professions, Lienhard School of Nursing 861 Bedford Road Pleasantville, NY 10570, USA.
Clinical Assistant Professor, Pace University, College of Health Professions, Lienhard School of Nursing 163 William Street, 5 Floor New York, NY 10036, USA.
Open Nurs J. 2018 Jan 22;12:1-14. doi: 10.2174/1874434601812010001. eCollection 2018.
Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice.
To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings.
An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings.
Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making.
A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions.
共同决策已引起医疗服务提供者、教育工作者、研究人员和政策制定者在国内和国际上的关注。关于共同决策的文献极为丰富，但大多关注共同决策的各个组成部分，而非一个全面的过程。这种对共同决策的观点让医疗服务提供者不知如何将共同决策融入实践。
从患者和医疗服务提供者在所有医疗环境中的角度，将共同决策理解为一个全面的过程。
采用系统方法进行综合综述，包括文献检索、数据评估和数据分析。检索范围涵盖1970年至2016年来自PubMed、CINAHL、Cochrane对照试验中央注册库和PsycINFO的文章。纳入的文章包括定量实验和非实验设计、定性研究以及关于所有医疗环境中医疗服务提供者与患者之间共同决策的理论文章。
本综合综述纳入了52篇论文。综合分析得出三个类别：（a）沟通/关系建立；（b）达成共同决策；（c）共同决策的行动。每个主要主题都包含子主题，这些子主题在共同决策的可视化表示中有所体现。
确定了对护士与患者之间共同决策的全面理解。可视化表示提供了一个指南，将共同决策描绘为在医疗互动过程中发生的一个过程，对随着时间推移持续进行共同决策具有影响，为患者提供了返回找护士重新考虑过去共同决策的机会。
