Pusey Emilia, Tinker Anthea, Lucivero Federica
St George's University of London, London, UK.
King's College London Institute of Gerontology, London, UK.
Work Older People. 2019 Jun 10;23(2):77-86. doi: 10.1108/WWOP-11-2018-0023.
The research question for this paper was: what are older adults' experiences of shared decision-making in a healthcare setting? This involved: Exploring older adults' experiences and opinions of decision-making in a healthcare setting;Understanding what shared decision-making means to older adults.
A qualitative study using face-to-face, semi-structured interviews with adults over 65 years. Thematic analysis was used.
Eight adults with a mean age of 76 years.
Three broad themes were identified which ascribed roles to individuals involved in decision making. This includes the way in which older adults felt they should be involved actively: by asking questions and knowing their own body. The doctors' role was described as assistive by facilitating discussion, giving options and advice. The role of the family was also explored; older adults felt the family could impact on their decisions in both a direct and indirect way. There was some confusion about what constituted a decision.
Older adults described what having an active role in decision making meant for them, but expected an assistive role from clinicians. They see their family as having an important role.
RESEARCH LIMITATIONS/IMPLICATIONS: This was a small qualitative study in one market town in England.
Clinicians should facilitate the involvement of older adults in shared decision making and consider how they can increase awareness of this. They should also involve the family in decision making.
ORIGINALITY/VALUE: There are limited studies which look at this issue in depth.
本文的研究问题是：老年人在医疗环境中共同决策的经历是怎样的？这包括：探索老年人在医疗环境中决策的经历和观点；理解共同决策对老年人意味着什么。
采用定性研究，对65岁以上成年人进行面对面的半结构化访谈。使用了主题分析法。
8名成年人，平均年龄76岁。
确定了三个广泛的主题，这些主题赋予了参与决策的个人角色。这包括老年人认为他们应如何积极参与：提问并了解自己的身体状况。医生的角色被描述为通过促进讨论、提供选择和建议来提供协助。还探讨了家庭的角色；老年人认为家庭会以直接和间接的方式影响他们的决策。对于什么构成决策存在一些困惑。
老年人描述了在决策中发挥积极作用对他们意味着什么，但期望临床医生发挥协助作用。他们认为家庭起着重要作用。
研究局限性/启示：这是在英国一个集镇进行的一项小型定性研究。
临床医生应促进老年人参与共同决策，并考虑如何提高对此的认识。他们还应让家庭参与决策。
原创性/价值：深入研究这一问题的研究有限。
