Shared decision making and advance care planning: a systematic literature review and novel decision-making model
Abstract Background and Aims Shared decision making (SDM) and advance care planning (ACP) are important evidence and ethics based concepts that can be translated in communication tools to aid the treatment decision-making process. Although both have been recommended in the care of patients with risk...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Medical Ethics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12910-023-00944-7 |
| _version_ | 1797556662543843328 |
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| author | Ana Rosca Isabelle Karzig-Roduner Jürgen Kasper Niek Rogger Daniel Drewniak Tanja Krones |
| author_facet | Ana Rosca Isabelle Karzig-Roduner Jürgen Kasper Niek Rogger Daniel Drewniak Tanja Krones |
| author_sort | Ana Rosca |
| collection | DOAJ |
| description | Abstract Background and Aims Shared decision making (SDM) and advance care planning (ACP) are important evidence and ethics based concepts that can be translated in communication tools to aid the treatment decision-making process. Although both have been recommended in the care of patients with risks of complications, they have not yet been described as two components of one single process. In this paper we aim to (1) assess how SDM and ACP is being applied, choosing patients with aortic stenosis with high and moderate treatment complication risks such as bleeding or stroke as an example, and (2) propose a model to best combine the two concepts and integrate them in the care process. Methods In order to assess how SDM and ACP is applied in usual care, we have performed a systematic literature review. The included studies have been analysed by means of thematic analysis as well as abductive reasoning to determine which SDM and ACP steps are applied as well as to propose a model of combining the two concepts into one process. Results The search in Medline, Cinahl, Embase, Scopus, Web of science, Psychinfo and Cochrane revealed 15 studies. Eleven describe various steps of SDM while four studies discuss the documentation of goals of care. Based on the review results and existing evidence we propose a model that combines SDM and ACP in one process for a complete patient informed choice. Conclusion To be able to make informed choices about immediate and future care, patients should be engaged in both SDM and ACP decision-making processes. This allows for an iterative process in which each important decision-maker can share their expertise and concerns regarding the care planning and advance care planning. This would help to better structure and prioritize information while creating a trustful and respectful relationship between the participants. PROSPERO 2019. CRD42019124575 |
| first_indexed | 2024-03-10T17:05:03Z |
| format | Article |
| id | doaj.art-8cd129cd0dbc4887931d16426693e6fb |
| institution | Directory Open Access Journal |
| issn | 1472-6939 |
| language | English |
| last_indexed | 2024-03-10T17:05:03Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Ethics |
| spelling | doaj.art-8cd129cd0dbc4887931d16426693e6fb2023-11-20T10:50:15ZengBMCBMC Medical Ethics1472-69392023-08-0124111110.1186/s12910-023-00944-7Shared decision making and advance care planning: a systematic literature review and novel decision-making modelAna Rosca0Isabelle Karzig-Roduner1Jürgen Kasper2Niek Rogger3Daniel Drewniak4Tanja Krones5Clinical ethics, Stadtspital ZürichInstitute of Biomedical Ethics and History of Medicine, Clinical Ethics, University of Zürich, University Hospital ZürichDepartment of Nursing and Health Promotion, Oslo metropolitan UniversitaUniversity of Applied Sciences LeidenInstitute of Biomedical Ethics and History of Medicine, University of ZürichInstitute of Biomedical Ethics and History of Medicine, Clinical Ethics, University of Zürich, University Hospital ZürichAbstract Background and Aims Shared decision making (SDM) and advance care planning (ACP) are important evidence and ethics based concepts that can be translated in communication tools to aid the treatment decision-making process. Although both have been recommended in the care of patients with risks of complications, they have not yet been described as two components of one single process. In this paper we aim to (1) assess how SDM and ACP is being applied, choosing patients with aortic stenosis with high and moderate treatment complication risks such as bleeding or stroke as an example, and (2) propose a model to best combine the two concepts and integrate them in the care process. Methods In order to assess how SDM and ACP is applied in usual care, we have performed a systematic literature review. The included studies have been analysed by means of thematic analysis as well as abductive reasoning to determine which SDM and ACP steps are applied as well as to propose a model of combining the two concepts into one process. Results The search in Medline, Cinahl, Embase, Scopus, Web of science, Psychinfo and Cochrane revealed 15 studies. Eleven describe various steps of SDM while four studies discuss the documentation of goals of care. Based on the review results and existing evidence we propose a model that combines SDM and ACP in one process for a complete patient informed choice. Conclusion To be able to make informed choices about immediate and future care, patients should be engaged in both SDM and ACP decision-making processes. This allows for an iterative process in which each important decision-maker can share their expertise and concerns regarding the care planning and advance care planning. This would help to better structure and prioritize information while creating a trustful and respectful relationship between the participants. PROSPERO 2019. CRD42019124575https://doi.org/10.1186/s12910-023-00944-7Shared decision makingAdvance care planningAortic stenosisSystematic literature reviewIntegrative model |
| spellingShingle | Ana Rosca Isabelle Karzig-Roduner Jürgen Kasper Niek Rogger Daniel Drewniak Tanja Krones Shared decision making and advance care planning: a systematic literature review and novel decision-making model BMC Medical Ethics Shared decision making Advance care planning Aortic stenosis Systematic literature review Integrative model |
| title | Shared decision making and advance care planning: a systematic literature review and novel decision-making model |
| title_full | Shared decision making and advance care planning: a systematic literature review and novel decision-making model |
| title_fullStr | Shared decision making and advance care planning: a systematic literature review and novel decision-making model |
| title_full_unstemmed | Shared decision making and advance care planning: a systematic literature review and novel decision-making model |
| title_short | Shared decision making and advance care planning: a systematic literature review and novel decision-making model |
| title_sort | shared decision making and advance care planning a systematic literature review and novel decision making model |
| topic | Shared decision making Advance care planning Aortic stenosis Systematic literature review Integrative model |
| url | https://doi.org/10.1186/s12910-023-00944-7 |
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