护理人员参与共享决策实践认知和体验质性研究的Meta整合

doi:10.16460/j.issn1008-9969.2022.21.032

摘要/Abstract

摘要： 目的整合护理人员参与共享决策实践认知和体验的质性研究,为护理人员参与和实施决策共享提供参考和依据。方法检索中国生物医学数据库、中国知网、万方、PubMed、Web of Science、CINAHL、Embase、Cochrane Library数据库中有关护理人员参与共享决策实践的认知和体验的质性研究,检索时限为建库至2022年10月。使用澳大利亚JBI循证卫生保健中心质性研究质量评价工具评价,汇集性整合方法进行整合。结果共纳入13篇文献,提取36个主题,归纳为11个类别和6个整合结果：护士混淆共享决策的概念;对实行共享决策持批判性态度;肯定和认同共享决策;在共享决策中经历负面体验;共享决策赋予了护士新的角色;护士参与共享决策需要增强自身素质和外部条件的支持。结论护士在共享决策中扮演了重要的角色,管理者要重视护士角色培养,根据护士需求提供培训和指导,发挥护士在共享决策中的角色价值。

关键词: 护理人员, 护士, 共享决策, 质性研究, Meta整合

Abstract: Objective To integrate the studies on experience of nurses’ participation in shared decision-making (SDM) and to provide reference for clinical practice. Methods Literature retrieval of qualitative research on nurses’ participation in SDM in SinoMed, CNKI, WanFang, PubMed, Web of Science, CINAHL, Embase, and Cochrane library was conducted from the inception to October, 2022. The JBI critical appraisal tool for qualitative studies was used to evaluate the quality of the included research,and the meta-aggregation to conduct the synthesis. Results Thirteen pieces of literature were included, and 36 themes were extracted and summarized into 11 categories and 6 integrated results: confused concepts; critical attitude towards SDM; identification with SDM; negative experience in SDM; new role endowed by SDM; improved quality in SDM and external support. Conclusion Nurses play an important role in SDM. Managers should pay attention to the role training of nurses, and provide training and guidance according to the needs of nurses, thus to give full play to the role value of nurses in SDM.

Key words: nursing staff, nurse, shared decisions, qualitative research, meta integration

中图分类号:

R192.6

林杨, 张勤娥, 张莉莉, 张文博, 徐宁. 护理人员参与共享决策实践认知和体验质性研究的Meta整合[J]. 护理学报, 2022, 29(21): 32-37.

LIN Yang, ZHANG Qin’e, ZHANG Li-li, ZHANG Wen-bo, XU Ning. Cognition and Experience of Nurses’ Participation in Shared Decision-making Practice: A Meta-analysis[J]. Journal of Nursing, 2022, 29(21): 32-37.

参考文献

[1] Healey J M.Making Health Care Decisions: President’s Commission for the Study of Ethnical Problems in Medicine and Biomedical and Behavioral Research[J]. Social Science & Medicine, 1984,18(12):1095.DOI:10.1016/0277-9536(84)90170-9.
[2] Vermeir P, Vandijck D, Degroote S, et al.Communication in Healthcare: A Narrative Review of the Literature and Practical Recommendations[J]. Int J Clin Pract, 2015,69(11): 1257-1267.DOI:10.1111/ijcp.12686.
[3] Aushu A, Steffensen KD, Olling K, et al.Practitioners’Views on Shared Decision-making Implementation: A Qualitative Study[J]. Plos One, 2021, 16(11):e0259844.DOI:10.1371/journal.pone.0259844.
[4] Kahveci R, Ayhan D, Doner P, et al.Shared Decision-Making in Pediatric Intensive Care Units: A Qualitative Study with Physicians, Nurses and Parents[J]. Indian Journal Of Pediatrics, 2014, 81(12):1287-1292. DOI:10.1007/s12098-014-1431-6.
[5] Roodbeen R, Vreke A, Boland G, et al.Communication and Shared Decision-making with Patients with Limited Health Literacy; Helpful Strategies, Barriers and Suggestions for Improvement Reported by Hospital-based Palliative Care Providers[J]. Plos One, 2020,15(6):e0234926.DOI:10.1371/journal.pone.0234926.
[6] 詹昱新, 喻姣花, 刘云访, 等. 护理人员对护患共享决策实践认知的质性研究[J]. 护理学杂志, 2021,36(1):56-59.DOI: 10.3870/j.issn.1001-4152.2021.01.056.
[7] 崔金锐, 肖琦, 柯键, 等. 老年终末期肾病患者共享决策体验质性研究的Meta整合[J]. 中华护理杂志, 2022,57(7): 863-871.DOI: 10.3761/j.issn.0254-1769.2022.07.016.
[8] Craig L, Zachary M, Kylie P.Qualitative Research Synthesis: Methodological Guidance for Systematic Reviewers Utilizing Meta-aggregation[J]. Int J Evid Based Healthc, 2015,13(3):179-87.DOI:10.1097/XEB.0000000000000062.
[9] 胡雁. 如何开展质性研究的系统评价和Meta整合[J]. 上海护理,2020,20(7):1-5.DOI:10.3969/j.issn.1009-8399.2020.07.001.
[10] 李丹, 冯兰棱, 樊落, 等. 护士对患者死亡认知与体验质性研究的Meta整合[J]. 护理学报, 2022,29(4):34-39.DOI:10.16460/j.issn1008-9969.2022.04.034.
[11] 胡雁, 彭健. 我国质性研究系统评价和Meta整合论文的质量评价[J]. 中国护理管理, 2020,20(4):490-495.DOI: 10.3969/j.issn.1672-1756.2020.04.004.
[12] Chung FF, Wang P, Lin S, et al.Shared Clinical Decision-making Experiences in Nursing: A Qualitative Study[J]. BMC Nurs, 2021,20(1):1-9.DOI:10.1186/s12912-021-00597-0.
[13] Truglio-Londrigan M.Shared Decision-making in Home-care from the Nurse’s Perspective: Sitting at the Kitchen Table - A Qualitative Descriptive Study[J]. J Clin Nurs, 2013,22(19-20):2883-2895. DOI:10.1111/jocn.12075.
[14] Danique DW, Thode M, Jongerden IP, et al.The Role of Hospital Nurses in Shared Decision-making about Life-prolonging Treatment: A Qualitative Interview Study[J]. J Adv Nurs, 2021,77(1):296-307.DOI:10.1111/jan.14549.
[15] Stephanie AL, Daniels R, Bokhoven MA, et al.What Makes It so Difficult for Nurses to Coach Patients in Shared Decision Making? A Process Evaluation[J]. Int Nurs Stud, 2018(80): 1-11.DOI:10.1016/j.ijnurstu.2017.12.005.
[16] Savelberg W, Boersma LJ, Smidt M, et al.Does Lack of Deeper Understanding of Shared Decision Making Explains the Suboptimal Performance on Crucial Parts of It? An Example from Breast Cancer Care[J]. Eur J Oncol Nurs, 2019(38): 92-97.DOI: 10.1016/j.ejon.2018.12.004.
[17] Rainier C, Lacanaria MGC.Nurses’ Concepts and Experiences in Shared Decision-Making[J]. JNPARR, 2020,10(2):48-56.
[18] Wubben N, Boogaard M, Hoeven JG, et al.Shared Decision-making in the ICU from the Perspective of Physicians, Nurses and Patients: A Qualitative Interview Study[J]. BMJ Open, 2021, 11(8):e050134.DOI:10.1136/bmjopen-2021-050134.
[19] Stoye A, Zimmer JM, Girndg M, et al.The Role of Different Nephrology Experts in Informed Shared Decision-making for Renal Replacement Therapy[J]. J Ren Care,2022,48(3):177-184.DOI:10.1111/jorc.12397.
[20] Steenbergen M, Vries J,Arits R,et al.Barriers and Facilitators for Shared Decision-making in Oncology Inpatient Practice: An Explorative Study of the Healthcare Providers’ Perspective[J]. Support Care Cancer, 2022,30(5):3925-3931.DOI:10.1007/s00520-022-06820-1.
[21] Charles C, Gafni A, Whelan T.Shared decision-making in the Medical Encounter: What Does It Mean? (Or It Takes At Least Two to Tango)[J]. Soc Sci Med, 1997,44(5):681-92.DOI:10.1016/s0277-9536(96)00221-3.
[22] Marjolein HJP, Fluit CRMG, Lagro J, et al.Expert and Patient Consensus on a Dynamic Model for Shared Decision-making in Frail Older Patients[J]. Patient Educ Couns,2016,99(6):1069-77.DOI:10.1016/j.pec.2015.12.014.
[23] Gainer R, Buth K, David J, et al.A Qualitative Analysis of Shared Decision Making in Cardiac Surgery[J]. Circ Cardiovasc Qual Outcomes, 2013,6(3):1941-7713. DOI:10.1161/CIRCOUTCOMES.117.004381.
[24] 庞建美, 张青月, 王小媛, 等. 医护人员实施乳腺癌患者决策辅助障碍及促进因素的质性研究[J]. 中华护理杂志, 2021,56(10):1516-1521.DOI:10.3761/j.issn.0254-1769.2021.10.012.

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