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考虑进行胚胎植入前遗传学检测的患者的决策需求:系统评价。

Decisional needs of patients considering preimplantation genetic testing: a systematic review.

机构信息

Prince of Wales Clinical School, Level 4, Lowy Cancer Research Centre, The University of New South Wales, Randwick NSW 2052, Australia.

Prince of Wales Clinical School, Level 4, Lowy Cancer Research Centre, The University of New South Wales, Randwick NSW 2052, Australia.

出版信息

Reprod Biomed Online. 2022 May;44(5):839-852. doi: 10.1016/j.rbmo.2021.12.011. Epub 2021 Dec 21.

Abstract

This systematic review reports on the needs and sources of support in patients' decision-making regarding the uptake of preimplantation genetic testing (PGT). Five databases were searched systematically to capture qualitative and quantitative studies. A total of 2336 studies were screened by title and abstract. Twelve studies met the eligibility criteria and reported on 4047 participants. This systematic review shows that patients need information directly relevant to PGT treatment, and information on health care relating to treatment and alternative reproductive options. Information that is too detailed, excessive and contains a large volume of medical terminology can be a barrier to decision-making. Published research suggests that health professionals provide general information on PGT and discuss it in detail only when patients require more information about it. Additionally, studies have shown that patients receive decisional support through mass media, significant persons in their lives and health professionals, whereas referring obstetricians and gynaecologists provided relatively less help compared with other health professionals. This systematic review highlights the importance of developing decision aids that meet patients' decisional needs as indicated in previous studies and that use innovative formats to deliver information. Additionally, given rapid technical developments, a dearth of continuing professional education is available on PGT for clinicians to keep updated.

摘要

本系统评价报告了患者在接受胚胎植入前遗传学检测(PGT)时的决策中对需求和支持来源的需求。我们系统地检索了五个数据库,以获取定性和定量研究。通过标题和摘要筛选了 2336 项研究。符合入选标准的研究有 12 项,报告了 4047 名参与者。本系统评价表明,患者需要直接与 PGT 治疗相关的信息,以及与治疗和其他生殖选择相关的医疗保健信息。信息过于详细、过多且包含大量医学术语可能会成为决策的障碍。已发表的研究表明,健康专业人员提供 PGT 的一般信息,只有当患者需要更多信息时才详细讨论。此外,研究表明,患者通过大众媒体、生活中的重要人物和健康专业人员获得决策支持,而与其他健康专业人员相比,妇产科医生提供的帮助相对较少。本系统评价强调了开发决策辅助工具的重要性,这些工具应满足先前研究中患者的决策需求,并使用创新的格式来提供信息。此外,鉴于技术的快速发展,临床医生在继续专业教育方面缺乏关于 PGT 的最新信息。

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