以患者为中心的物质使用障碍护理与患者结局之间的关系：一项范围综述。
The relationship between patient-centred care for substance use disorders and patient outcomes: A scoping review.
作者信息
Myers Bronwyn, Da Silva Nicholas, McLaughlin Stella, Purnomo Jessika, Shumskaya Daria, Koume Kaori, Suhartono Sanita, Campello Giovanna, Busse Anja
机构信息
Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Australia; Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, South Africa; Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Australia.
出版信息
Int J Drug Policy. 2025 May;139:104770. doi: 10.1016/j.drugpo.2025.104770. Epub 2025 Mar 13.
BACKGROUND
Patient-centred care (PCC) is considered crucial for high-quality substance use disorder (SUD) treatment and care, but it is unclear whether PCC is associated with enhanced outcomes. This review aimed to map available evidence of the relationship between PCC and outcomes across the SUD treatment continuum.
METHODS
We conducted a scoping review of the literature on the relationship between PCC for SUD and service outcomes in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Six electronic databases were searched for peer-reviewed articles published in English between January 1994 and June 2024. After screening 5268 titles and abstracts and 186 full texts in duplicate, data were extracted from 135 articles and narratively synthesized according to six PCC dimensions (therapeutic alliance, shared decision-making, personalised supports, integrated care for co-occurring disorders, trauma-informed and culturally-informed care).
RESULTS
The findings from this review suggest largely positive associations between these PCC components and the outcomes of generalist and specialist SUD services. Few studies (<1 %) assessed more than one PCC dimension. The therapeutic alliance was the most frequently assessed dimension (35.6 %, 48/135 articles), followed by shared decision-making (16.3 %, 22/135 articles), trauma-informed care (14.8 %, 20/135 articles), integrated care (13.3 %, 18/135 articles), and personalised services (13.3 %, 18/135 articles). PCC in generalist services was associated with greater SUD treatment utilization and fewer adverse events. PCC in specialist SUD treatment was largely associated with better SUD outcomes.
CONCLUSIONS
This review highlighted evidence gaps on the relationship between PCC and SUD service outcomes, with literature scant for some PCC dimensions and studies typically examining a single dimension of PCC. More research is needed to understand the relative importance of each PCC dimension for predicting SUD service outcomes, how these dimensions interact to influence outcomes, and to develop and evaluate interventions for enhancing PCC.
背景
以患者为中心的护理（PCC）被认为对高质量的物质使用障碍（SUD）治疗和护理至关重要，但尚不清楚PCC是否与更好的治疗结果相关。本综述旨在梳理整个SUD治疗过程中PCC与治疗结果之间关系的现有证据。
方法
我们根据系统评价和Meta分析扩展的范围综述首选报告项目（PRISMA-ScR）指南，对关于SUD的PCC与服务结果之间关系的文献进行了范围综述。检索了六个电子数据库，以查找1994年1月至2024年6月期间以英文发表的同行评审文章。在对5268篇标题和摘要以及186篇全文进行重复筛选后，从135篇文章中提取数据，并根据六个PCC维度（治疗联盟、共同决策、个性化支持、共病综合护理、创伤知情护理和文化知情护理）进行叙述性综合分析。
结果
本综述的结果表明，这些PCC组成部分与全科和专科SUD服务的结果之间在很大程度上呈正相关。很少有研究（<1%）评估了多个PCC维度。治疗联盟是评估最频繁的维度（35.6%，48/135篇文章），其次是共同决策（16.3%，22/135篇文章）、创伤知情护理（14.8%，20/135篇文章）、综合护理（13.3%，18/135篇文章）和个性化服务（13.3%，18/135篇文章）。全科服务中的PCC与更高的SUD治疗利用率和更少的不良事件相关。专科SUD治疗中的PCC在很大程度上与更好的SUD结果相关。
结论
本综述突出了PCC与SUD服务结果之间关系的证据空白，一些PCC维度的文献较少，且研究通常只考察了PCC的一个维度。需要更多的研究来了解每个PCC维度对预测SUD服务结果的相对重要性、这些维度如何相互作用以影响结果，以及开发和评估增强PCC的干预措施。
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