University of Virginia School of Nursing, 225 Jeanette Lancaster Way, Charlottesville, VA, 22903, USA.
University of Virginia Health Library, 1350 Jefferson Park Avenue, VA, 22908, Charlottesville, USA.
Support Care Cancer. 2022 Dec 31;31(1):94. doi: 10.1007/s00520-022-07556-8.
PURPOSE: Shared decision making (SDM) among the oncology population is highly important due to complex screening and treatment decisions. SDM among patients with cancer, caregivers, and clinicians has gained more attention and importance, yet few articles have systematically examined SDM, specifically in the adult oncology population. This review aims to explore SDM within the oncology literature and help identify major gaps and concerns, with the goal to provide guidance in the development of clear SDM definitions and interventions. METHODS: We conducted a scoping review using the Arksey and O'Malley approach along with the PRISMA Extension for Scoping Reviews Checklist. A systematic search was conducted in four databases that included publications since 2016. RESULTS: Of the 364 initial articles, eleven publications met the inclusion criteria. We included articles that were original research, cancer related, and focused on shared decision making. Most studies were limited in defining SDM and operationalizing a model of SDM. There were several concerns revealed related to SDM: (1) racial inequality, (2) quality and preference of the patient, caregiver, and clinician communication is important, and (3) the use of a decision-making aid or tool provides value to the patient experience. CONCLUSION: Inconsistencies regarding the meaning and operationalization of SDM and inequality of the SDM process among patients from different racial/ethnic backgrounds impact the health and quality of care patients receive. Future studies should clearly and consistently define the meaning of SDM and develop decision aids that incorporate bidirectional, interactive communication between patients, caregivers, and clinicians that account for the diversity of racial, ethnic, and sociocultural backgrounds and preferences.
目的:由于复杂的筛查和治疗决策,肿瘤患者之间的共享决策(SDM)非常重要。癌症患者、护理人员和临床医生之间的 SDM 已经引起了更多的关注和重视,但很少有文章系统地研究了 SDM,特别是在成年肿瘤患者中。本综述旨在探讨肿瘤学文献中的 SDM,并帮助确定主要差距和关注点,旨在为明确 SDM 定义和干预措施提供指导。
方法:我们使用 Arksey 和 O'Malley 方法以及 PRISMA 扩展清单进行了范围综述。在四个数据库中进行了系统搜索,包括自 2016 年以来的出版物。
结果:在最初的 364 篇文章中,有 11 篇符合纳入标准。我们纳入了原始研究、癌症相关且专注于共享决策的文章。大多数研究在定义 SDM 和实施 SDM 模型方面存在局限性。有几个与 SDM 相关的问题被揭示出来:(1)种族不平等,(2)患者、护理人员和临床医生沟通的质量和偏好很重要,以及(3)决策辅助工具的使用为患者体验提供了价值。
结论:关于 SDM 的含义和实施的不一致性,以及来自不同种族/族裔背景的患者在 SDM 过程中的不平等,会影响患者所接受的健康和护理质量。未来的研究应明确和一致地定义 SDM 的含义,并开发决策辅助工具,在患者、护理人员和临床医生之间建立双向、互动的沟通,考虑到种族、民族和社会文化背景以及偏好的多样性。
Support Care Cancer. 2022-12-31
Patient Educ Couns. 2023-5
J Gen Intern Med. 2018-7-20
BMC Med Inform Decis Mak. 2020-8-12
J Med Internet Res. 2025-2-21
JMIR Med Inform. 2022-8-9
Support Care Cancer. 2019-2-8
Asia Pac J Oncol Nurs. 2025-8-19