Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States.
School of Nursing, Johns Hopkins University, Baltimore, MD, United States; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States.
Int J Nurs Stud. 2019 Apr;92:79-89. doi: 10.1016/j.ijnurstu.2019.01.006. Epub 2019 Jan 24.
The decision partner concept emerged to describe someone who contributes to healthcare decision-making with a patient. There is a need for greater precision and consensus surrounding its conceptual definition and use in broader populations.
To define and describe the decision partner concept within the context of healthcare decision-making.
A concept analysis.
We searched the following databases for articles published between 1990-2017: PsychINFO, PubMed, Embase, and CINAHL. We included qualitative, quantitative, or mixed methods studies that used the term decision partner in the context of healthcare decision-making.
We applied the Walker and Avant method to identify the antecedents, attributes, related concepts, consequences, and empirical referents of the concept, with major themes identified.
From the 112 articles included in this concept analysis, 6 defining attributes of decision partner were identified: (1) has a relationship with the patient, (2) demonstrates a willingness to participate in decision-making, (3) articulates a clear understanding of both the patient's health condition and the decisions that must be made, (4) demonstrates decision-making self-efficacy; (5) exemplifies an emotional capacity to participate in decision-making, and (6) willing to fulfill several supportive roles including patient advocate and the "hub of information".
A unifying definition and discussion of the decision partner concept has been developed. Our findings: (1) offer insights into refining the concept across various diseases and healthcare encounters, (2) contribute to developing theoretical models and empirical research to refine antecedents, attributes, consequences, (3) serve as a foundation to develop instruments to measure the concept and (4) highlight the need to design interventions that include and support decision partners in healthcare decision-making.
决策伙伴这一概念的出现是为了描述在医疗保健决策中与患者共同做出决策的人。目前需要更加精确地定义和达成共识，以明确其概念定义，并在更广泛的人群中使用。
在医疗保健决策背景下定义和描述决策伙伴的概念。
概念分析。
我们在 1990 年至 2017 年期间，在以下数据库中搜索了描述医疗保健决策中使用决策伙伴的文章：心理信息、PubMed、Embase 和 CINAHL。我们纳入了使用决策伙伴一词的定性、定量或混合方法研究。
我们应用沃克和奥凡特方法来识别概念的前因、属性、相关概念、后果和实证参照，确定主要主题。
从本次概念分析纳入的 112 篇文章中，确定了决策伙伴的 6 个定义属性：(1)与患者有关系；(2)表现出参与决策的意愿；(3)明确理解患者的健康状况和必须做出的决策；(4)表现出决策自我效能；(5)表现出参与决策的情感能力；(6)愿意承担患者代言人及“信息枢纽”等多个支持性角色。
已经制定了决策伙伴概念的统一定义和讨论。我们的发现：(1)为在各种疾病和医疗保健环境中完善该概念提供了见解；(2)有助于开发理论模型和实证研究，以完善前因、属性和后果；(3)为开发衡量该概念的工具提供了基础；(4)强调了在医疗保健决策中设计包括并支持决策伙伴的干预措施的必要性。
