Chae Heemin, Ji Hee-Ju, Moon Hyunjung, Lee Yeongeun, Son Youn-Jung
Department of Nursing, The Graduate School, Chung-Ang University, Seoul, Republic of Korea.
Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.
Asia Pac J Oncol Nurs. 2025 Aug 19;12:100775. doi: 10.1016/j.apjon.2025.100775. eCollection 2025 Dec.
The lack of a clear and unified definition of shared decision-making (SDM) may hinder its effective application in oncology care. This study aims to clarify the concept of SDM specifically in the context of early-stage breast cancer treatment through an evolutionary concept analysis.
A systematic search was conducted across PubMed, CINAHL, PsycINFO, Cochrane, and EMBASE databases for articles published from January 2015 to December 2024. Using keywords "shared decision-making" and "breast cancer," relevant studies were identified, and key attributes of SDM were extracted and synthesized. Sixteen studies met the inclusion criteria.
SDM for early-stage breast cancer treatment was characterized by 10 attributes spanning three levels: 1) Patient perspective: involvement in decision-making, values and preferences regarding treatment options, and deliberative thinking to achieve choice certainty; 2) Healthcare professional perspective: provision of individualized information, psychological support, consultation focused on patients' best interests, collaborative partnerships with patients, coordinated care delivery, and promotion of person-centered, informed choices; 3) Healthcare system level: fostering a patient-centered healthcare culture.
These findings provide a comprehensive conceptual framework to guide the development of detailed SDM guidelines tailored for early-stage breast cancer patients. Enhanced understanding of SDM can support nurses and healthcare professionals in facilitating collaborative and optimal decision-making processes within oncology care. Furthermore, this study lays the groundwork for developing measurement tools and disease-specific interventions to advance SDM implementation in early-stage breast cancer treatment.
PROSPERO (CRD42024587218).
缺乏对共同决策（SDM）清晰统一的定义可能会阻碍其在肿瘤护理中的有效应用。本研究旨在通过进化概念分析，明确SDM在早期乳腺癌治疗背景下的具体概念。
在PubMed、CINAHL、PsycINFO、Cochrane和EMBASE数据库中进行系统检索，查找2015年1月至2024年12月发表的文章。使用关键词“共同决策”和“乳腺癌”，识别相关研究，并提取和综合SDM的关键属性。16项研究符合纳入标准。
早期乳腺癌治疗的SDM具有10个属性，分为三个层次：1）患者视角：参与决策、对治疗方案的价值观和偏好，以及通过审慎思考以确定选择；2）医疗专业人员视角：提供个性化信息、心理支持、以患者最佳利益为重点的咨询、与患者的合作关系、协调护理提供，以及促进以患者为中心的知情选择；3）医疗系统层面：培育以患者为中心的医疗文化。
这些发现提供了一个全面的概念框架，以指导为早期乳腺癌患者量身定制详细的SDM指南的制定。对SDM的深入理解可以支持护士和医疗专业人员在肿瘤护理中促进协作和优化决策过程。此外，本研究为开发测量工具和针对特定疾病的干预措施奠定了基础，以推进SDM在早期乳腺癌治疗中的实施。
PROSPERO（CRD42024587218）。
