Faculty of Medicine Vrije Universiteit Amsterdam, Research in Education, Amsterdam UMC, de Boelelaan1118 1081 HZ Amsterdam, the Netherlands; LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University, Van der Boechorststraat 1 1081 BT Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Van der Boechorststraat 7 1081 BT Amsterdam, the Netherlands.
UMC Utrecht, Location Wilhelmina Kinderziekenhuis, Lundlaan 6 3584 EA Utrecht, the Nederlands.
Patient Educ Couns. 2020 Oct;103(10):2069-2077. doi: 10.1016/j.pec.2020.04.019. Epub 2020 May 14.
Gaining insight into contextual factors and mechanisms supporting or hindering autonomy supportive consultation and into outcomes of such consultations.
We conducted a systematic review using the realist synthesis procedure according to RAMESES guideline. A search was performed in PubMed, Embase, PsycINFO and Cinahl from inception to March 2019 using the search terms: 'autonomy' AND 'support' AND 'consultation' OR 'communication' AND 'intervention'. The review process including paper selection, quality assessment, full text reading for data-extraction was conducted by two researchers independently.
Of 2792 articles, 18 met our inclusion criteria. Contextual factors influencing an autonomy supportive consultation were: work organization and the attitude of professionals. An overarching supporting mechanism for AS was relationship building. In addition, each phase of the decision-making process seems to need supporting mechanisms fulfilling patients 'specific psychological needs in that phase. The outcome of AS is higher levels of patient well-being.
Autonomy supportive consultation works under various contexts coupled with mechanisms that give rise to favourable-outcomes, of which relationship building, taking time and exploring patients' needs seem the most important.
The results of our review facilitate professionals to reflect on their autonomy supportive consultation skills, which could improve their autonomy supportive behaviour.
深入了解支持或阻碍自主支持性咨询的背景因素和机制，以及此类咨询的结果。
我们根据 RAMESES 指南使用系统综述的真实综合程序进行了研究。从开始到 2019 年 3 月，我们在 PubMed、Embase、PsycINFO 和 Cinahl 中使用了以下搜索词进行了搜索：'自主'和'支持'和'咨询'或'沟通'和'干预'。两名研究人员独立进行了论文选择、质量评估和全文阅读以提取数据的审查过程。
在 2792 篇文章中，有 18 篇符合我们的纳入标准。影响自主支持性咨询的背景因素包括：工作组织和专业人员的态度。支持 AS 的一个总体机制是建立关系。此外，决策过程的每个阶段似乎都需要满足患者在该阶段特定心理需求的支持机制。AS 的结果是更高水平的患者幸福感。
自主支持性咨询在各种背景下发挥作用，并伴随着产生有利结果的机制，其中建立关系、花时间和探索患者的需求似乎最为重要。
我们的综述结果有助于专业人员反思他们的自主支持性咨询技能，从而提高他们的自主支持性行为。
