School of Nursing, Jilin University, Changchun, China.
The Second Hospital of Jilin University, Changchun, China.
J Clin Nurs. 2023 Apr;32(7-8):1025-1044. doi: 10.1111/jocn.16328. Epub 2022 Apr 22.
To systematically evaluate the effects of decision aids for women facing breast reconstruction decision on decision conflict, decision regret, knowledge, satisfaction, anxiety and depression.
Breast reconstruction decision is not good or bad and should be guided by clinical evidence and patient preferences. Decision aids can increase the patient's decision-making enthusiasm and ability, improve the quality of decision and promote shared decision-making between patients and medical staff.
Systematic review and meta-analysis.
Eight databases were conducted from the establishment of the database until October 2021. The PRISMA checklist was selected for analysis in this paper. The meta-analysis was conducted in Review Manager 5.3. The quality of the studies was assessed using the Cochrane risk-of-bias tool. The result is decision conflict, decision regret, knowledge and other secondary outcomes. Sensitivity analysis and subgroup analysis were also conducted.
A total of twelve randomised controlled trials (RCTs) were included in the systematic review and meta-analysis. Meta-analysis revealed that decision aids could significantly reduce decision conflict and decision regret, improve knowledge, satisfaction and depression and had no influence on anxiety.
The results of the systematic review and meta-analysis reviewed the positive effect of decision aids on the decision-making of women facing postmastectomy breast reconstruction. In the future, more well-designed RCTs are needed to confirm the effects of decision aids on the decision-making of breast reconstruction and nurses should be encouraged to take part in the development of decision aids in accordance with strict standards and apply them to breast cancer patients considering postmastectomy breast reconstruction.
Our study provides evidence for the effectiveness of decision aids on breast reconstruction and points to the important role of healthcare providers in the use of decision aids and in facilitating shared decision-making.
系统评价针对面临乳房重建决策的女性的决策辅助工具对决策冲突、决策后悔、知识、满意度、焦虑和抑郁的影响。
乳房重建决策没有好坏之分，应根据临床证据和患者偏好进行指导。决策辅助工具可以提高患者的决策积极性和能力，改善决策质量，促进医患之间的共同决策。
系统评价和荟萃分析。
从数据库建立到 2021 年 10 月，对 8 个数据库进行了检索。本文选择 PRISMA 清单进行分析。使用 Review Manager 5.3 进行荟萃分析。使用 Cochrane 偏倚风险工具评估研究质量。结果是决策冲突、决策后悔、知识等次要结果。还进行了敏感性分析和亚组分析。
系统评价和荟萃分析共纳入 12 项随机对照试验（RCT）。荟萃分析显示，决策辅助工具可以显著降低决策冲突和决策后悔，提高知识、满意度和抑郁水平，对焦虑无影响。
系统评价和荟萃分析的结果回顾了决策辅助工具对接受乳房重建的女性决策的积极影响。未来需要更多设计良好的 RCT 来证实决策辅助工具对乳房重建决策的影响，并鼓励护士根据严格标准参与决策辅助工具的开发，并将其应用于考虑接受乳房重建的乳腺癌患者。
本研究为决策辅助工具在乳房重建方面的有效性提供了证据，并指出医疗保健提供者在使用决策辅助工具和促进共同决策方面的重要作用。
