Li Mengnan, Fu Guang, Mo Wenjuan, Yan Yuanyuan, Chen Xi, Li Xiong
School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of University of South China, Hengyang, People's Republic of China.
Ann Surg Oncol. 2025 Apr 16. doi: 10.1245/s10434-025-17317-6.
Over the past 50 years, doctor-patient interactions have moved from paternalistic to patient-centered, emphasizing shared decision-making (SDM). SDM, which involves healthcare professionals and patients making clinical decisions together, is crucial for patient autonomy and is promoted worldwide, yet remains challenging to implement effectively. Our systematic review analyses the influencing factors of implementing shared decision-making in patients with colorectal cancer and summarizes coping strategies.
A systematic search of the PubMed, Embase, Cochrane Library, Web of Science (Core library), Ovid, and EBSCO databases was performed from database inception to 1 September 2024 using a combination of subject words and free words. Qualitative studies on the factors affecting SDM for patients with gastrointestinal cancer were identified, the literature quality was evaluated using the Australian JBI Evidence-based Health Care Center quality evaluation standards for qualitative research, and the results were integrated by a pooled integration method.
A total of 37 results were extracted through meta-analysis, summarized into 9 themes, and summarized into 2 subthemes. The results were classified for nonmutually exclusive cases.
Medical staff should fully understand patients' needs and preferences for disease and treatment information, strengthen their communication skills regarding SDM, and actively provide effective treatment and care information for patients and their families to promote the implementation of SDM for patients with gastrointestinal tumors.
在过去50年中，医患互动模式已从家长式转向以患者为中心，强调共同决策（SDM）。共同决策是指医疗专业人员和患者共同做出临床决策，这对患者自主权至关重要，并且在全球范围内得到推广，但有效实施仍具有挑战性。我们的系统评价分析了在结直肠癌患者中实施共同决策的影响因素，并总结应对策略。
从数据库建立至2024年9月1日，使用主题词和自由词相结合的方式，对PubMed、Embase、Cochrane图书馆、科学网（核心库）、Ovid和EBSCO数据库进行系统检索。识别关于影响胃肠道癌患者共同决策因素的定性研究，采用澳大利亚JBI循证卫生保健中心定性研究质量评价标准对文献质量进行评价，并通过汇总整合方法整合结果。
通过荟萃分析共提取37项结果，归纳为9个主题，并总结为2个子主题。对结果进行分类以处理非互斥情况。
医务人员应充分了解患者对疾病和治疗信息的需求及偏好，加强关于共同决策的沟通技巧，并积极为患者及其家属提供有效的治疗和护理信息，以促进胃肠道肿瘤患者共同决策的实施。
