Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia; National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, SA, Australia.
School of Psychology, The University of Adelaide, Adelaide, SA, 5005, Australia.
Patient Educ Couns. 2021 Oct;104(10):2439-2452. doi: 10.1016/j.pec.2021.02.035. Epub 2021 Feb 20.
To synthesise a body of fine-grained observational research on communication between healthcare professionals (HCPs), older adults, and carers regarding self-management goals and actions.
We conducted a systematic review, searching nine electronic databases and the grey literature. Two reviewers independently selected for inclusion following a two-stage process and studies and discrepancies were resolved through consultation with the review team.
898 records were retrieved, and eight studies were included in the review. Aggregative thematic analysis resulted in 13 categories of communication practices across three decision-making domains: (1) initiating: actions occurring prior to the commitment point; (2) proposing: putting forward a course of action; and (3) committing and closing: committing (or not) to the course of action.
Despite an increasing emphasis on the importance of personalised care planning and shared decision-making (SDM) to support older people's health and wellbeing, HCPs did not consistently practice this approach and, in some cases, worked in opposition to it.
We encourage HCPs to prepare older adults to engage actively with SDM and the goal setting process by employing patient-centred communication resources. These could assist with identifying different types of goals that are realistic and relevant to patients in daily life.
综合大量关于医疗保健专业人员（HCP）、老年人和照顾者之间关于自我管理目标和行动的沟通的精细观察性研究。
我们进行了系统评价，搜索了九个电子数据库和灰色文献。两名审查员按照两阶段程序独立进行纳入选择，通过与审查团队协商解决研究和差异。
共检索到 898 条记录，有 8 项研究纳入综述。聚合主题分析产生了三个决策领域的 13 类沟通实践：（1）启动：承诺点之前发生的行动；（2）提出：提出行动方案；（3）承诺和结束：承诺（或不承诺）采取行动。
尽管越来越强调个性化护理计划和共同决策（SDM）对支持老年人的健康和幸福的重要性，但 HCP 并没有始终如一地采用这种方法，在某些情况下，甚至违背了这种方法。
我们鼓励 HCP 使用以患者为中心的沟通资源，使老年人为积极参与 SDM 和目标设定过程做好准备。这些资源可以帮助确定在日常生活中对患者来说现实和相关的不同类型的目标。
