护理学报 ›› 2024, Vol. 31 ›› Issue (10): 53-58.doi: 10.16460/j.issn1008-9969.2024.10.053
精神科医护人员共享决策促进和障碍因素质性研究的Meta整合
许娇1, 黄柳2, 王娟1, 韩利1, 鲍玉洁1, 邓季秋1
- 1.武汉市精神卫生中心,湖北 武汉 430000;
2.三峡大学基础医学院,湖北 宜昌 443000
摘要： 目的 系统评价精神科医护人员的共享决策体验,为更好辅助患者决策提供参考依据。方法 计算机检索PubMed、Embase、The Cochrane Library、Web of Science和中国知网、维普数据库、万方数据库,收集关于精神科医护人员共享决策体验的质性研究,检索时限为建库至2024年3月。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价纳入文献的质量,采用汇集性整合方法对结果进行整合。结果 共纳入19项原始研究,提炼出65个主题,归纳13个类别,最后形成3个整合结果：精神科医护人员的共享决策过程中的矛盾心理、共享决策感知障碍因素、共享决策感知促进因素。结论 精神科医护人员在实施共享决策的过程中较为矛盾,感知多方面的障碍因素和促进因素。因此,要不断提高医护人员对共享决策认知和态度,不断予培训课程和信息共享方法,促进共享决策在精神科领域的发展。
中图分类号:
- R473.74
| [1] Mucci A, Kawohl W, Maria C,et al.Treating schizophrenia: open conversations and stronger relationships through psychoeducation and shared decision-making[J]. Front Psychiatry, 2020,11(1):761-769. DOI: 10.3389/fpsyt.2020.00761. [2] Hamann J, Holzhüter F, Blakaj S, et al.Implementing shared decision-making on acute psychiatric wards: a cluster randomized trial with inpatients suffffering from schizophrenia (SDM-PLUS)[J]. Epidemiol Psychiatr Sci,2020,29(1):137-144. DOI: 10.1017/S2045796020000505. [3] 杨鹤林,李静静,耿彤,等. 精神分裂症患者及家属参与医疗决策的意愿[J]. 中国心理卫生杂志,2014,28(3):179-184. DOI: 10.3969/j.issn.1000-6729.2014.03.004. [4] Huang C, Plumme V, Yun W, et al.I am the person who knows myself best: perception on shared decision making among hospitalized people diagnosed with schizophrenia in China[J]. Int J Ment Health Nurs, 2020, 29(5):846-855. DOI: 10.1111/inm.12718. [5] Huang C, Lam L, Zhong Y, et al.Chinese mental health professionals' perceptions of shared decision-making regarding people diagnosed with schizophrenia: a qualitative study[J]. Int J Ment Health Nurs, 2021, 30(1):189-199. DOI: 10.1111/inm.12771_1. [6] Hamann J, Heres S.Adapting shared decision making for individuals with severe mental illness[J]. Psychiatr Serv, 2014(65):1483-1486. DOI: 10.1176/appi.ps.201400307. [7] Beitinger R, Kissling W, Hamann J.Trends and perspectives of shared decision-making in schizophrenia and related disorders[J]. Curr Opin Psychiatry,2014,27(1):222-229. DOI: 10.1097/YCO.0000000000000057. [8] 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. [9] 林杨,张勤娥,张莉莉,等.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. DOI: 10.16460/j.issn1008-9969.2022.21.032. [10] 胡雁. 循证护理学[M]. 北京:人民卫生出版社,2012:130-141. [11] Stacey G, Felton A, Morgan A,et al.A critical narrative analysis of shared decision-making in acute inpatient mental health care[J]. J Interprof Care, 2016, 30(1):35-41. DOI: 10.3109/13561820.2015.1064878. [12] Abrines-Jaume N, Midgley N, Hopkins K,et al.A qualitative analysis of implementing shared decision making in child and adolescent mental health services in the United Kingdom: Stages and facilitators[J].Clin Child Psychol Psychiatry, 2014,21(1):19-31.DOI:10.1177/1359104514547596. [13] Becher S, Fabian Holzhüter, Heres S, et al.Barriers and facilitators of shared decision making in acutely ill inpatients with schizophrenia—qualitative findings from the intervention group of a randomised-controlled trial[J]. Health Expect, 2021, 24(1): 1737-1746. DOI: 10.1111/hex.13313. [14] Farrelly S, Lester H, Rose D, et al.Barriers to shared decision making in mental health care: qualitative study of the Joint Crisis Plan for psychosis[J].Health Expect, 2016, 19(1): 448-458. DOI: 10.1111/hex.12368. [15] Hayes D, Edbrooke-Childs J, Town R, et al.Barriers and facilitators to shared decision making in child and youth mental health: clinician perspectives using the Theoretical Domains Framework[J]. Eur Child Adolesc Psychiatry, 2019, 28(1): 655-666. DOI: 10.1007/s00787-018-1230-0.[16] Huang C, Lam L, Zhong Y, et al. Chinese mental health professionals' perceptions of shared decision-making regarding people diagnosed with schizophrenia: a qualitative study[J].Int J Ment Health Nurs, 2021, 30(1): 189-199. DOI10.1111/inm.12771_1. [17] Hilden HM, Hautamäki L, Korkeila J.Clinicians' experiences on patients' demands and shared decision making in Finnish specialized mental health care[J]. Nord J Psychiatry, 2021, 75(3):194-200. DOI: 10.1080/08039488.2020.1833983. [18] Haugom EW, Stensrud B, Beston G,et al.Mental health professionals' experiences with shared decision-making for patients with psychotic disorders: a qualitative study[J].BMC Health Services Research, 2020, 20(1):1093-1104. DOI: 10.1186/s12913-020-05949-1. [19] Schn UK, Grim K, Wallin L, et al.Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study[J].Int J Qual Stud Health Well-being, 2018, 13(1):1-12. DOI: 10.1080/17482631.2017.1421352. [20] Wesseldijk-Elferink IJM, Hendriks AW, van den Heuvel SCGH. Shared decision making in a semi-secluded chronic psychiatric ward: the reflective lifeworld experiences of patients with schizophrenia or schizoaffective disorders and nursing staff[J]. Arch Psychiatr Nurs, 2021,35(5):519-525. DOI: 10.1016/j.apnu.2021.07.007. [21] Mahone IH, Farrell S, Hinton I, et al.Shared decision making in mental health treatment: qualitative findings from stakeholder focus groups[J]. Arch Psychiatr Nurs, 2011, 25(6):e27-e36. DOI: 10.1016/j.apnu.2011.04.003. [22] Chong WW, Aslani P, Chen TF.Shared decision-making and interprofessional collaboration in mental healthcare: a qualitative study exploring perceptions of barriers and facilitators[J]. J Interprof Care, 2013, 27(5):373-379. DOI: 10.3109/13561820.2013.785503. [23] Beyene LS, Severinsson E, Hansen BS,et al.Shared decision-making-balancing between power and responsibility as mental health-care professionals in a therapeutic milieu[J]. Sage Open Nurs, 2018, 4(1):1-10. DOI:10.1177/2377960817752159. [24] Bjonness S, Viksveen P, Johannessen JO, et al.User participation and shared decision-making in adolescent mental healthcare: a qualitative study of healthcare professionals' perspectives[J]. Child Adolesc Psychiatry Ment Health, 2020, 14(1): 2-11. DOI: 10.1186/s13034-020-0310-3. [25] Hamann J, Kohl S, Mccabe R, et al.What can patients do to facilitate shared decision making? A qualitative study of patients with depression or schizophrenia and psychiatrists[J]. Soc Psychiatry Psychiatr Epidemiol, 2016, 51(4):617-625. DOI: 10.1007/s00127-015-1089-z. [26] Kaminskiy E, Zisman-Ilani Y, Ramon S.Barriers and enablers to shared decision making in psychiatric medication management: a qualitative investigation of clinician and service users' views[J].Front Psychiatry, 2021(12):678005. DOI: 10.3389/fpsyt.2021.678005. [27] Lin CY, Renwick L, Lovell K, Health professionals' perspectives on shared decision-making in secondary mental healthcare: a qualitative study[J]. J Ment Health,2022,31(5):709-715. DOI: 10.1080/09638237.2021.2022608. [28] Maples NJ, Velligan DI, Jones EC, el at. Perspectives of patients and providers in using shared decision making in psychiatry[J]. Community Ment Health J,2022,58(3):578-588. DOI: 10.1007/s10597-021-00856-z. [29] Brooks H, Harris K, Bee P, et al.Exploring the potential implementation of a tool to enhance shared decision making (SDM) in mental health services in the United Kingdom: a qualitative exploration of the views of service users, carers and professionals[J].Int J Ment Health Syst, 2017,11(28):42-54. DOI: 10.1186/s13033-017-0149-z. [30] 郭理想,黄娟,豆丽园, 等.肿瘤科护士共享决策知信行现状及影响因素调查[J].护理学杂志,2021, 36(9):54-57.DOI: 10.3870/j.issn.1001-4152.2021.09.054. [31] Beitinger R, Kissling W, Hamann J.Trends and perspectives of shared decision-making in schizophrenia and related disorders[J]. Curr Opin Psychiatry, 2014,27(1):222-229. DOI: 10.1097/YCO.0000000000000057. [32] Lavik KO, Veseth M, Binder PE, et al.‘Nobody else can lead your life': What adolescents need from psychotherapists in change processes[J].Counselling and Psychotherapy Research, 2018,18(3):262-273.DOI:10.1002/capr.12166. [33] 肖霖,彭美芳,刘亚玮,等. 癌症患者参与能力对其感知医患共同决策水平的影响[J]. 护理学杂志,2022,37(20):42-45. DOI: 10.3870/j.issn.1001-4152.2022.20.042. [34] 王子琪. 门诊患者参与能力与感知价值关系研究:价值共创行为的中介作用视角[D].成都:成都中医药大学,2021. [35] Jeste DV, Depp CA, Palmer BW.Magnitude of impairment in decisional capacity in people with schizophrenia compared to normal subjects: an overview[J]. Schizophr Bull, 2006(32):121-128. DOI: 10.1093/schbul/sbj001. [36] Ishii M, Okumura Y, Sugiyama N, et al.Feasibility and efficacy of shared decision making for first-admission schizophrenia: a randomized clinical trial[J].BMC Psychiatry, 2017, 17(1):52. DOI: 10.1186/s12888-017-1218-1. [37] 朱展慧,林征,周美景,等. 决策辅助工具在炎症性肠病患者中应用的范围综述[J]. 护理学报, 2022,29(7):44-49. DOI: 10.16460/j.issn1008-9969.2022.07.044. |
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