Department of Pharmacy, National University of Singapore, Singapore, Singapore.
Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA5042, Australia.
J Cancer Surviv. 2024 Apr;18(2):288-317. doi: 10.1007/s11764-022-01230-y. Epub 2022 Jul 7.
To elucidate existing decision aids (DAs) in supporting cancer survivors' decisions to engage in cancer survivorship care services after primary treatment. Secondary objectives are to assess the DA acceptability, impact of DAs, and implementation barriers.
Databases (PubMed, Embase, PsycINFO, CINAHL) were searched to collect publications from inception through September 2021. Studies describing the development or evaluation of DAs used for survivorship care services after primary cancer treatment were included. Article selection and critical appraisal were conducted independently by two authors.
We included 16 studies that described 13 DAs and addressed multiple survivorship care domains: prevention of recurrence/new cancers in Hodgkin lymphoma survivors and breast cancer gene mutation carriers, family building options, health insurance plans, health promotion (substance use behavior, cardiovascular disease risk reduction), advanced care planning, and post-treatment follow-up intensity. The electronic format was used to design most DAs for self-administration. The content presentation covered decisional context, options, and value clarification exercises. DAs were acceptable and associated with higher knowledge but presented inconclusive decisional outcomes. Implementation barriers included lack of design features for connectivity to care, low self-efficacy, and low perceived DA usefulness among healthcare professionals. Other survivor characteristics included age, literacy, preferred timing, and setting.
A diverse range of DAs exists in survivorship care services engagement with favorable knowledge outcomes. Future work should clarify the impact of DAs on decisional outcomes.
DA characterization and suggestions for prospective developers could enhance support for cancer survivors encountering complex decisions throughout the survivorship continuum.
阐明现有的决策辅助工具（DAs）在支持癌症幸存者在完成主要治疗后参与癌症生存护理服务方面的作用。次要目标是评估 DA 的可接受性、影响和实施障碍。
从建库开始至 2021 年 9 月，我们在 PubMed、Embase、PsycINFO 和 CINAHL 等数据库中检索文献，以收集关于主要癌症治疗后生存护理服务使用的 DA 开发或评估研究。由两名作者独立进行文章选择和批判性评价。
我们纳入了 16 项研究，描述了 13 种 DA，涉及多个生存护理领域：霍奇金淋巴瘤幸存者和乳腺癌基因突变携带者的复发/新发癌症预防、生育选择、健康保险计划、健康促进（物质使用行为、心血管疾病风险降低）、预先护理计划和治疗后随访强度。大多数 DA 采用电子格式设计，供自我管理使用。内容呈现涵盖决策背景、选项和价值澄清练习。DA 具有可接受性，与更高的知识水平相关，但决策结果不明确。实施障碍包括缺乏与护理的连接设计功能、自我效能低以及医疗保健专业人员对 DA 实用性的认知度低。其他幸存者特征包括年龄、文化程度、首选时间和环境。
在参与生存护理服务的决策中，存在多种不同的 DA，具有良好的知识效果。未来的工作应该阐明 DA 对决策结果的影响。
DA 的特征描述和对未来开发者的建议可以增强对癌症幸存者在整个生存过程中遇到复杂决策的支持。
