From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Anesth Analg. 2019 May;128(5):1030-1035. doi: 10.1213/ANE.0000000000003804.
Patient decision aids are educational tools used by health care providers to assist patients in choosing their treatment and care. The use of anesthesia-related patient decision aids can help practitioners provide patient-centered care by facilitating shared decision-making. The benefits of these aids have been well documented, yet a structured approach for developing patient decision aids in anesthesia has not been well established. Educating patients on various anesthesia-related options is paramount in their decision-making, yet accessible and validated resources are limited. In addition, many limitations exist with current patient decision aids that must be addressed. We have reviewed multiple processes for developing decision aids and have suggested a structured approach to their creation. We address the common limitations of current patient decision aids and provide improvements to the developmental process. Improvements include increasing patient input during development, thoroughly evaluating data included in the aids, and integrating a cyclic review of the aids before and after their use. Using the provided developmental process and checklist, anesthesia providers can create evidence-based patient decision aids in a standardized manner. It is important to evaluate decision aids and measure their decision quality, or patient-centeredness, to further improve them and maximize their effectiveness. Moving forward, development of proper metrics for patient participation and decision quality are required.
患者决策辅助工具是医疗保健提供者使用的教育工具，用于帮助患者选择治疗和护理方案。使用与麻醉相关的患者决策辅助工具可以通过促进共同决策，帮助从业者提供以患者为中心的护理。这些辅助工具的好处已经得到充分证明，但在麻醉学中开发患者决策辅助工具的结构化方法尚未得到很好的建立。教育患者了解各种与麻醉相关的选择对于他们的决策至关重要，但可用且经过验证的资源有限。此外，目前的患者决策辅助工具存在许多必须解决的限制。我们已经审查了多种开发决策辅助工具的流程，并提出了一种创建决策辅助工具的结构化方法。我们解决了当前患者决策辅助工具的常见限制，并对开发过程进行了改进。改进包括在开发过程中增加患者的投入，彻底评估辅助工具中包含的数据，并在使用前和使用后对辅助工具进行循环审查。使用提供的开发流程和清单，麻醉师可以以标准化的方式创建基于证据的患者决策辅助工具。评估决策辅助工具并衡量其决策质量或以患者为中心的程度，以进一步改进它们并最大限度地提高它们的效果非常重要。展望未来，需要制定适当的患者参与和决策质量指标。
