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远程共享决策通过远程医疗实现:文献系统综述。

Remote shared decision making through telemedicine: A systematic review of the literature.

机构信息

Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.

出版信息

Patient Educ Couns. 2022 Feb;105(2):356-365. doi: 10.1016/j.pec.2021.06.012. Epub 2021 Jun 11.

Abstract

OBJECTIVES

To assess the extent to which shared decision making (SDM) can take place in telemedicine (remote SDM).

METHODS

We searched Medline, Cochrane, and Scopus from 2010 until August 7th, 2020 for articles on remote SDM in the care of any patient using any technology. We also conducted a search for telemedicine articles citing key reports on SDM outcome measures. Two reviewers independently screened titles and abstracts, reviewed full text eligible studies, and synthesized their content using thematic analysis.

RESULTS

Of the 12 eligible articles, most were European with patients with chronic disease or mental and behavioral health. 8 articles used synchronous remote SDM and 1 used asynchronous remote SDM. Themes related to interactional workability of both telemedicine technologies and SDM emerged, namely access to broadband, digital literacy, and satisfaction with the convenience of remote visits.

CONCLUSIONS

Telemedicine technologies may foster virtual interactions that support remote SDM, which, in turn, may promote productive patient-clinician interactions and patient-centered care.

PRACTICE IMPLICATIONS

Digitally-mediated consultations surged amidst the COVID-19 pandemic. The extent to which SDM frameworks developed for in-person use need any adaptation for remote SDM remains unclear. Investment in innovation, design, implementation, and effectiveness research to advance remote SDM are needed.

摘要

目的

评估远程医疗(远程共享决策)中共享决策(SDM)的实施程度。

方法

我们从 2010 年至 2020 年 8 月 7 日在 Medline、Cochrane 和 Scopus 上搜索了使用任何技术为任何患者提供护理的远程 SDM 的文章。我们还搜索了引用 SDM 结果衡量标准关键报告的远程医疗文章。两位审查员独立筛选标题和摘要,审查合格的全文研究,并使用主题分析综合其内容。

结果

在 12 篇合格的文章中,大多数来自欧洲,患者患有慢性病或精神和行为健康问题。8 篇文章使用同步远程 SDM,1 篇文章使用异步远程 SDM。出现了与远程医疗技术和 SDM 的交互可操作性相关的主题,即宽带接入、数字素养以及对远程就诊便利性的满意度。

结论

远程医疗技术可以促进支持远程 SDM 的虚拟互动,反过来又可以促进富有成效的医患互动和以患者为中心的护理。

实践意义

在 COVID-19 大流行期间,数字化介导的咨询激增。针对面对面使用而开发的 SDM 框架是否需要针对远程 SDM 进行任何调整尚不清楚。需要投资于创新、设计、实施和有效性研究,以推进远程 SDM。

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