Department of Biomedical Data Sciences, Leiden University Medical Center, the Netherlands; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA; Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Universidad Autónoma de Barcelona, Barcelona, Spain.
Patient Educ Couns. 2024 Aug;125:108285. doi: 10.1016/j.pec.2024.108285. Epub 2024 Apr 22.
Time is often perceived as a barrier to shared decision making in cancer care. It remains unclear how time functions as a barrier and how it could be most effectively utilized.
This scoping review aimed to describe the role of time in patient involvement, and identify strategies to overcome time-related barriers.
Seven databases were searched for any publications on patient involvement in cancer treatment decisions, focusing on how time is used to involve patients, the association between time and patient involvement, and/or strategies to overcome time-related barriers. Reviewers worked independently and in duplicate to select publications and extract data. One coder thematically analyzed data, a second coder checked these analyses.
The analysis of 26 eligible publications revealed four themes. Time was a resource 1) to process the diagnosis, 2) to obtain/process/consider information, 3) for patients and clinicians to spend together, and 4) for patient involvement in making decisions.
Time is a resource throughout the treatment decision-making process, and generic strategies have been proposed to overcome time constraints.
Clinicians could co-create decision-making timelines with patients, spread decisions across several consultations, share written information with patients, and support healthcare redesigns that allocate the necessary time.
时间常常被视为癌症护理中共同决策的障碍。目前尚不清楚时间如何成为障碍，以及如何最有效地利用时间。
本范围综述旨在描述时间在患者参与中的作用，并确定克服与时间相关障碍的策略。
在七个数据库中搜索了关于患者参与癌症治疗决策的任何出版物，重点关注如何利用时间来让患者参与，时间与患者参与之间的关联，以及/或克服与时间相关障碍的策略。审查员独立并重复工作以选择出版物和提取数据。一名编码员对数据进行主题分析，第二名编码员检查这些分析。
对 26 篇合格出版物的分析揭示了四个主题。时间是一种资源 1）用于处理诊断，2）用于获取/处理/考虑信息，3）用于患者和临床医生一起度过，以及 4）用于患者参与决策。
时间是治疗决策过程中的一种资源，已经提出了通用策略来克服时间限制。
临床医生可以与患者共同制定决策时间表，将决策分散在几次咨询中，与患者分享书面信息，并支持医疗保健重新设计，以分配必要的时间。
