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Shared decision making in surgery: A scoping review of the literature
- Source :
- Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background Shared decision making (SDM) has been increasingly implemented to improve health‐care outcomes. Despite the mixed efficacy of SDM to provide better patient‐guided care, its use in surgery has not been studied. The aim of this study was to systematically review SDM application in surgery. Design The search strategy, developed with a medical librarian, included nine databases from inception until June 2019. After a 2‐person title and abstract screen, full‐text publications were analysed. Data collected included author, year, surgical discipline, location, study duration, type of decision aid, survey methodology and variable outcomes. Quantitative and qualitative cross‐sectional studies, as well as RCTs, were included. Results A total of 6060 studies were retrieved. A total of 148 were included in the final review. The majority of the studies were in plastic surgery, followed by general surgery and orthopaedics. The use of SDM decreased surgical intervention rate (12 of 22), decisional conflict (25 of 29), and decisional regret (5 of 5), and increased decisional satisfaction (17 of 21), knowledge (33 of 35), SDM preference (13 of 16), and physician trust (4 of 6). Time increase per patient encounter was inconclusive. Cross‐sectional studies showed that patients prefer shared treatment and surgical treatment varied less. The results of SDM per type of decision aid vary in terms of their outcome. Conclusion SDM in surgery decreases decisional conflict, anxiety and surgical intervention rates, while increasing knowledge retained decisional satisfaction, quality and physician trust. Surgical patients also appear to prefer SDM paradigms. SDM appears beneficial in surgery and therefore worth promoting and expanding in use.
- Subjects :
- medicine.medical_specialty
Patients
media_common.quotation_subject
Decision Making
shared decision making
Decisional conflict
surgery
03 medical and health sciences
Survey methodology
0302 clinical medicine
Intervention (counseling)
medicine
Humans
Quality (business)
030212 general & internal medicine
patient‐centred care
media_common
business.industry
030503 health policy & services
Public Health, Environmental and Occupational Health
Preference
Surgery
Original Research Paper
Cross-Sectional Studies
Orthopedic surgery
Anxiety
Patient Participation
medicine.symptom
0305 other medical science
business
Decision Making, Shared
Original Research Papers
Surgical patients
Subjects
Details
- ISSN :
- 13697625 and 13696513
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Health Expectations
- Accession number :
- edsair.doi.dedup.....daaaaaa7232422fac6780a9180a0cddd