我国慢性病患者决策参与影响因素质性研究的系统评价

Factors influencing participation in decision-making among patients with chronic diseases in China:a systematic review of qualitative research

目的系统评价我国慢性病患者医疗决策参与的影响因素,为医护人员改进医疗决策工作模式、促进患者参与提供参考。方法计算机检索国内外数据库,收集关于我国慢性病患者医疗决策参与行为和参与意向的质性研究。对纳入研究进行方法学质量评价后,采用主题综合法进行结果整合。结果共纳入10项研究,提炼42个描述性主题,归纳出12个分析性主题,总结出4个关键性主题(决策参与意愿、决策参与能力、社会支持与支持来源方干扰、医疗环境)。结论影响我国慢性病患者决策参与的因素较多,医护人员应评估慢性病患者真实的决策参与意愿和能力,采取多样化决策辅助手段,提高患者决策参与程度。

Objective To systematically evaluate the factors influencing participation in medical decision-making among patients with chronic diseases in China,and to provide reference for improving decision-making participation patterns and patients′participation.Methods Literature regarding qualitative studies on behaviors and intention to participation in medical decision-making among patients with chronic diseases in China,were retrieved in some common electronic databases.After evaluation of quality of included studies,the results were integrated by thematic synthesis.Results Ten studies were included.A total of 42 descriptive themes were extracted,then 12 analytical themes were generated and 4 core themes were identified:willingness to participation in decision-ma-king,participation ability,social support and interference from support source,as well as medical environment.Conclusion Participation in medical decision-making among Chinese patients with chronic diseases is affected by many factors.Medical personnel should assess willingness and ability of patients to participate in decision-making,and adopt diversified decision aids to enhance patient participation in decision-making.