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电子评估工具能否改善共同决策过程?系统评价。

Can electronic assessment tools improve the process of shared decision-making? A systematic review.

机构信息

University of Sheffield, UK.

Newcastle University, UK.

出版信息

Health Inf Manag. 2023 May;52(2):72-86. doi: 10.1177/1833358320954385. Epub 2020 Oct 5.

Abstract

BACKGROUND

Patient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients' history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making.

OBJECTIVE

To assess the effectiveness of electronic assessment tools to improve the shared decision-making process.

METHOD

A systematic review was conducted following PRISMA guidelines. Published literature was searched on MEDLINE, EMBASE and PsycINFO to identify potentially relevant studies. Data were extracted and analysed narratively.

RESULTS

Seventeen articles, representing 4004 participants, were included in this review. The main findings were significant improvement in patient-provider communication and provider management of patient condition in the intervention group compared to the control group. In contrast, patient-provider satisfaction and time efficiency were assessed by relatively few included studies, and the effects of these outcomes were inconclusive.

CONCLUSION

This review found that communication and healthcare professional's management of a patient's condition improves because of the use of electronic questionnaires. This is encouraging because the process of shared decision-making is reliant on high-quality communication between healthcare professionals and patients.

IMPLICATIONS

We found that this intervention is especially important for people with chronic diseases, as they need to establish a long-term relationship with their healthcare provider and agree to a treatment plan that aligns with their values. More rigorous research with validated instruments is required.

摘要

背景

患者参与决策在提高医疗保健质量方面起着重要作用。尽管如此,共同决策并未常规实施。然而,医疗保健专业人员在患者就诊期间使用电子评估工具来记录患者的病史、症状、意见和价值观,以促进共同决策。

目的

评估电子评估工具在改善共同决策过程方面的有效性。

方法

按照 PRISMA 指南进行系统评价。在 MEDLINE、EMBASE 和 PsycINFO 上搜索已发表的文献,以确定潜在相关的研究。提取和分析数据进行叙述性分析。

结果

这项综述纳入了 17 篇文章,代表 4004 名参与者。主要发现是干预组与对照组相比,患者与提供者之间的沟通以及提供者对患者病情的管理有显著改善。相比之下,患者与提供者的满意度和时间效率是由相对较少的纳入研究评估的,这些结果的影响尚无定论。

结论

这项综述发现,由于电子问卷的使用,沟通和医疗保健专业人员对患者病情的管理得到了改善。这是令人鼓舞的,因为共同决策的过程依赖于医疗保健专业人员和患者之间的高质量沟通。

意义

我们发现,这种干预措施对患有慢性疾病的人尤其重要,因为他们需要与他们的医疗保健提供者建立长期关系,并同意符合他们价值观的治疗计划。需要使用经过验证的工具进行更严格的研究。

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