School of Nursing, University of Wisconsin, Madison, USA.
William S. Middleton Memorial Veterans Hospital, Madison, USA; Department of Psychiatry, University of Wisconsin, School of Medicine and Public Health, Madison, USA.
Patient Educ Couns. 2018 Nov;101(11):1884-1891. doi: 10.1016/j.pec.2018.06.017. Epub 2018 Jun 28.
To summarize the evidence regarding the factors and processes of treatment decision making involving a person with dementia (PWD) in the acute care setting.
We conducted a scoping review, searching 4 databases (PubMed, CINAHL, Web of Science, & PsychINfo) for articles that contained primary data from a quantitative or qualitative study involving treatment decision making in the acute care setting for PWD and were published in English. We categorized the factors and processes of decision making identified in each article using inductive content analysis. We also consulted with healthcare practitioners to receive stakeholder input on our findings.
Our search initially revealed 12,478 articles, of which 28 were included in the review. We identified 5 categories of factors that influence the decision-making process: knowing the patient, culture and systems, role clarity, appropriateness of palliative care in dementia, and caregiver need for support.
Our findings highlight the complexities of the decision-making process and the importance of attending to the needs of the caregiver, healthcare practitioners, and the patient.
It is important to address beliefs of involving palliative care for a PWD and the role of each healthcare discipline.
总结涉及急性护理环境中痴呆症患者（PWD）的治疗决策因素和过程的证据。
我们进行了范围界定审查，在 4 个数据库（PubMed、CINAHL、Web of Science 和 PsychINFO）中搜索了包含 PWD 在急性护理环境中进行治疗决策的主要数据的定量或定性研究的文章，且这些文章必须以英文发表。我们使用归纳内容分析对每篇文章中确定的决策因素和过程进行了分类。我们还咨询了医疗保健从业者，以获取利益相关者对我们研究结果的意见。
我们的搜索最初显示了 12478 篇文章，其中 28 篇被纳入了综述。我们确定了影响决策过程的 5 类因素：了解患者、文化和系统、角色明确、痴呆症姑息治疗的适宜性以及照顾者对支持的需求。
我们的研究结果强调了决策过程的复杂性，以及关注照顾者、医疗保健从业者和患者需求的重要性。
解决涉及姑息治疗 PWD 的信念以及每个医疗保健学科的作用非常重要。
