scholarly journals Which instruments are used to measure shared, supported and assisted healthcare decision-making between patients who have limited, impaired or fluctuating capacity, their family carers and healthcare professionals? A systematic review protocol

2020 ◽  
Vol 2 ◽  
pp. 19
Author(s):  
Francesco Fattori ◽  
Deirdre O'Donnell ◽  
Beatriz Rodríguez-Martín ◽  
Thilo Kroll
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Healthcare Professionals ◽  
Data Extraction ◽  
Treatment Plan ◽  
Cognitive Capacity ◽  
Healthcare Decision ◽  
Family Carers ◽  
Healthcare Decision Making ◽  
Psychometric Instruments

Background: Shared decision-making (SDM) is a dialogical relationship where the physician and the patient define the problem, discuss the available options according to the patient’s values and preferences, and co-construct the treatment plan. Undertaking SDM in a clinical setting with patients who have limited, impaired or fluctuating cognitive capacity may prove challenging. Supported (defined “Assisted” in the Irish context) decision-making describes how people with impaired or fluctuating capacity remain in control of their healthcare-related choices through mechanisms which build and maximise capacity. Supported and assisted decision-making (ADM) within healthcare settings is theoretically and practically novel. Therefore, there is a knowledge gap about the validity of psychometric instruments used to assess ADM and its components within clinical settings. This systematic review aims to identify and characterise instruments currently used to assess shared, supported and assisted healthcare decision-making between patients with limited, impaired or fluctuating capacity, their family carers and healthcare professionals. Methods: A systematic review and narrative synthesis will be performed using a search strategy involving the following databases (PubMed, Cinahl, Embase, Web of Science, Scopus and PsycINFO). Quantitative studies published in the last decade and describing psychometric instruments measuring SDM, supported decision-making and ADM with people having limited or fluctuating capacity will be considered eligible for inclusion. Title and abstract screening will be followed by full-text eligibility screening, data extraction, synthesis and analysis. This review will be structured and reported according to the PRISMA checklist. The COSMIN Risk of bias checklist will be used to assess the quality of the instruments. Discussion: The results will inform and be useful to HCPs and policymakers interested in having updated knowledge of the available instruments to assess SDM, supported and assisted healthcare decision-making between patients who have impaired or fluctuating capacity, their family carers and healthcare professionals. Registration: PROSPERO CRD42018105360; registered on 10/08/2018.

scholarly journals Which instruments are used to measure shared, supported and assisted healthcare decision-making between patients who have limited, impaired or fluctuating capacity, their family carers and healthcare professionals? A systematic review protocol

2019 ◽  
Vol 2 ◽  
pp. 19
Author(s):  
Francesco Fattori ◽  
Deirdre O'Donnell ◽  
Beatriz Rodríguez-Martín ◽  
Thilo Kroll
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Healthcare Professionals ◽  
Data Extraction ◽  
Treatment Plan ◽  
Cognitive Capacity ◽  
Healthcare Decision ◽  
Family Carers ◽  
Healthcare Decision Making ◽  
Psychometric Instruments

Background: Shared decision-making (SDM) is a dialogical relationship where the physician and the patient define the problem, discuss the available options according to the patient’s values and preferences, and co-construct the treatment plan. Undertaking SDM in a clinical setting with patients who have limited, impaired or fluctuating cognitive capacity may prove challenging. Supported (defined “Assisted” in the Irish context) decision-making describes how people with impaired or fluctuating capacity remain in control of their healthcare-related choices through mechanisms which build and maximise capacity. Supported and assisted decision-making (ADM) within healthcare settings is theoretically and practically novel. Therefore, there is a knowledge gap about the validity of psychometric instruments used to assess ADM and its components within clinical settings. This systematic review aims to identify and characterise instruments currently used to assess shared, supported and assisted healthcare decision-making between patients with limited, impaired or fluctuating capacity, their family carers and healthcare professionals. Methods: A systematic review and narrative synthesis will be performed using a search strategy involving the following databases (PubMed, Cinahl, Embase, Web of Science, Scopus and PsycINFO). Quantitative studies published in the last decade and describing psychometric instruments measuring SDM, supported decision-making and ADM with people having limited or fluctuating capacity will be considered eligible for inclusion. Title and abstract screening will be followed by full-text eligibility screening, data extraction, synthesis and analysis. This review will be structured and reported according to the PRISMA checklist. The COSMIN Risk of bias checklist will be used to assess the quality of the instruments. Discussion: The results will inform and be useful to HCPs and policymakers interested in having updated knowledge of the available instruments to assess SDM, supported and assisted healthcare decision-making between patients who have impaired or fluctuating capacity, their family carers and healthcare professionals. Registration: PROSPERO CRD42018105360; registered on 10/08/2018.

A Systematic Review to Identify the Use of Preference Elicitation Methods in Healthcare Decision Making

2014 ◽  
Vol 28 (4) ◽  
pp. 175-185 ◽  
Author(s):  
Marieke G. M. Weernink ◽  
Sarah I. M. Janus ◽  
Janine A. van Til ◽  
Dennis W. Raisch ◽  
Jeannette G. van Manen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Preference Elicitation ◽  
Healthcare Decision ◽  
Elicitation Methods ◽  
Healthcare Decision Making

scholarly journals Can electronic assessment tools improve the process of shared decision-making? A systematic review

2020 ◽  
pp. 183335832095438
Author(s):  
Nyantara Wickramasekera ◽  
Sarah K Taylor ◽  
Elizabeth Lumley ◽  
Thomas Gray ◽  
Emma Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Shared Decision Making ◽  
Healthcare Professionals ◽  
Treatment Plan ◽  
Intervention Group ◽  
Assessment Tools ◽  
Control Group ◽  
Shared Decision ◽  
Electronic Assessment

Background: Patient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients’ history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making. Objective: To assess the effectiveness of electronic assessment tools to improve the shared decision-making process. Method: A systematic review was conducted following PRISMA guidelines. Published literature was searched on MEDLINE, EMBASE and PsycINFO to identify potentially relevant studies. Data were extracted and analysed narratively. Results: Seventeen articles, representing 4004 participants, were included in this review. The main findings were significant improvement in patient–provider communication and provider management of patient condition in the intervention group compared to the control group. In contrast, patient–provider satisfaction and time efficiency were assessed by relatively few included studies, and the effects of these outcomes were inconclusive. Conclusion: This review found that communication and healthcare professional’s management of a patient’s condition improves because of the use of electronic questionnaires. This is encouraging because the process of shared decision-making is reliant on high-quality communication between healthcare professionals and patients. Implications: We found that this intervention is especially important for people with chronic diseases, as they need to establish a long-term relationship with their healthcare provider and agree to a treatment plan that aligns with their values. More rigorous research with validated instruments is required.

scholarly journals Nursing Home Staff’s Perceptions of Healthcare Decision Making for Unbefriended Residents

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 384-384
Author(s):  
Hyejin Kim ◽  
Molly Perkins ◽  
Thaddeus Pope ◽  
Patricia Comer ◽  
Mi-Kyung Song
Keyword(s):  
Decision Making ◽  
Geographic Area ◽  
Care Physician ◽  
Healthcare Decision ◽  
Do Not Resuscitate ◽  
Best Interest ◽  
Care Plans ◽  
Course Of Action ◽  
Healthcare Decision Making ◽  
Facility Level

Abstract ‘Unbefriended’ adults are those who lack decision-making capacity and have no surrogates or advance care plans. Little data exist on nursing homes (NHs)’ healthcare decision-making practices for unbefriended residents. This study aimed to describe NH staff’s perceptions of healthcare decision making on behalf of unbefriended residents. Sixty-six staff including administrators, physicians, nurses, and social workers from three NHs in one geographic area of Georgia, USA participated in a 31-item survey. Their responses were analyzed using descriptive statistics and conventional content analysis. Of 66 participants, eleven had been involved in healthcare decision-making for unbefriended residents. The most common decision was do-not-resuscitate orders. Decisions primarily were made by relying on the resident’s primary care physician and/or discussing within a facility interdisciplinary team. Key considerations in the decision-making process included “evidence that the resident would not have wanted further treatment” and the perception that “further treatment would not be in the resident’s best interest”. Compared with decision making for residents with surrogates, participants perceived decision making for unbefriended residents to be equally-more difficult. Key barriers to making decisions included uncertainty regarding what the resident would have wanted in the given situation and concerns regarding the ethically and legally right course of action. Facilitators (reported by 52 participants) included some information/knowledge about the resident, an understanding regarding decision-making-related law/policy, and facility-level support. The findings highlight the complexity and difficulty of healthcare decision making for unbefriended residents and suggest more discussions among all key stakeholders to develop practical strategies to support decision-making practices in NHs.

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