Sorensen von Essen Helle, Piil Karin, Dahl Steffensen Karina, Rom Poulsen Frantz
Department of Neurosurgery, Odense University Hospital, Odense C, Denmark.
Department of Clinical Research and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), University of Southern Denmark, Odense C, Denmark.
Neurooncol Pract. 2020 Jul 24;7(6):589-598. doi: 10.1093/nop/npaa042. eCollection 2020 Dec.
Shared decision making (SDM) has proven to be a valuable approach in different patient populations when treatment decisions are called for. Along the disease trajectory of high-grade glioma (HGG), patients are presented with a series of treatment decisions. At the same time, HGG patients often experience cognitive deterioration and reduced decision-making capacity. This study aimed to review the current knowledge about shared decision making from the perspective of the HGG patient.
Systematic searches were performed in MEDLINE, CINAHL, PsycINFO, and EMBASE. Studies were reviewed against the inclusion criteria and assessed for methodological quality. Descriptive data from the included studies were extracted and a narrative synthesis of the findings was performed.
The searches resulted in 5051 original records. Four studies involving 178 HGG patients fulfilled the inclusion criteria. The narrative synthesis revealed that most HGG patients in the included studies appreciated an SDM approach and that sufficient information and involvement increased patients' emotional well-being. The use of a patient decision aid showed the potential to increase knowledge, decrease uncertainty, and affect the treatment decision making of HGG patients.
The results indicate that many HGG patients prefer an SDM approach and that SDM can lead patients toward improved emotional well-being. The evidence is weak, however, and firm conclusions and practice guidelines concerning SDM in HGG patients cannot be made. Future research is warranted to improve decision support for HGG patients.
在需要做出治疗决策时，共同决策（SDM）已被证明是一种适用于不同患者群体的有价值方法。在高级别胶质瘤（HGG）的疾病发展过程中，患者面临一系列治疗决策。同时，HGG患者常经历认知衰退和决策能力下降。本研究旨在从HGG患者的角度回顾有关共同决策的现有知识。
在MEDLINE、CINAHL、PsycINFO和EMBASE中进行系统检索。根据纳入标准对研究进行审查，并评估其方法学质量。提取纳入研究的描述性数据，并对结果进行叙述性综合分析。
检索结果得到5051条原始记录。四项涉及178名HGG患者的研究符合纳入标准。叙述性综合分析表明，纳入研究中的大多数HGG患者赞赏共同决策方法，充足的信息和参与可提高患者的情绪幸福感。使用患者决策辅助工具显示出增加知识、减少不确定性以及影响HGG患者治疗决策的潜力。
结果表明，许多HGG患者更喜欢共同决策方法，且共同决策可使患者情绪幸福感得到改善。然而，证据不足，无法就HGG患者的共同决策得出确凿结论并制定实践指南。未来有必要开展研究以改善对HGG患者的决策支持。
