PDF(Pubmed)
Abstract：
UNASSIGNED: Multiple sclerosis (MS) is a chronic autoimmune inflammatory, demyelinating, and neurodegenerative disease affecting young adults. People with MS are highly interested in engaging in physical symptom management and decision-making but are often not actively engaged in symptom management discussions. Research examining the benefit of shared decision-making in the management of physical MS symptoms is sparse.
UNASSIGNED: This study aimed to identify and synthesize the evidence on the use of shared decision-making in physical MS symptom management.
UNASSIGNED: This study is a systematic review of published evidence on the use of shared decision-making in physical MS symptom management.
UNASSIGNED: MEDLINE, CINAHL, EMBASE, and CENTRAL databases were searched in April 2021, June 2022, and April 2, 2023, for primary, peer-reviewed studies of shared decision-making in the management of MS physical symptoms. Citations were screened, data extracted, and study quality assessed according to Cochrane guidelines for systematic reviews, including risk of bias assessment. Statistical synthesis of the included study results was not appropriate; results were summarized in a nonstatistical manner using the vote-counting method to estimate beneficial versus harmful effects.
UNASSIGNED: Of 679 citations, 15 studies met the inclusion criteria. Six studies addressed shared decision-making in the management of pain, spasms, neurogenic bladder, fatigue, gait disorder, and/or balance issues, and nine studies addressed physical symptoms in general. One study was a randomized controlled trial; most studies were observational studies. All study results and study author conclusions indicated that shared decision-making is important to the effective management of physical MS symptoms. No study results suggested that shared decision-making was harmful or delayed the management of physical MS symptoms.
UNASSIGNED: Reported results consistently indicate that shared decision-making is important in effective MS symptomatic care. Further rigorous randomized controlled trials are warranted to investigate the effectiveness of shared decision-making associated with MS physical symptomatic care.
UNASSIGNED: PROSPERO: CRD42023396270.
Shared decision-making among people with Multiple Sclerosis (MS) and their healthcare providers in the management of the physical symptoms of MS. Shared decision-making is suggested to be a key mechanism in promoting optimal symptomatic care related to Multiple Sclerosis (MS). Shared decision-making is mostly done and studied in relation to choosing therapies that may slow disease progression but not usually for symptomatic care. There are a few studies highlighting the effect of utilizing shared decision-making in symptomatic care of MS. We performed this study to identify all the published data about using shared decision-making in symptomatic care in MS to answer the research question: What is the evidence on shared decision-making in managing physical MS symptoms? We performed a systematic search for all the related published study results in four large literature databases. We found 15 studies on the use of shared decision-making in the management of MS-related symptoms. We synthesized the study results relating to the use of shared decision-making in symptomatic care of MS. The studies used several different designs and included a wide range of study rigor and quality. The results of our systematic review are: All the studies were consistent in their conclusions that shared decision-making is important for effective MS-related symptom management.Several studies found that symptomatic care is of the highest priority to people with MS, but not often a priority to their health care providers.The use of a shared decision-making model can promote discussion of symptoms in clinical consultations and align the goals of people with MS and their health care providers.Education of people with MS regarding their symptoms and available treatments will promote effective shared decision-making discussions. The available evidence supports that the use of shared decision-making is beneficial to the management of physical symptoms of MS. Further studies using a randomized controlled study design are required to establish the degree of benefit of utilizing shared decision-making associated with MS symptomatic care.
UNASSIGNED: This study aimed to identify and synthesize the evidence on the use of shared decision-making in physical MS symptom management.
UNASSIGNED: This study is a systematic review of published evidence on the use of shared decision-making in physical MS symptom management.
UNASSIGNED: MEDLINE, CINAHL, EMBASE, and CENTRAL databases were searched in April 2021, June 2022, and April 2, 2023, for primary, peer-reviewed studies of shared decision-making in the management of MS physical symptoms. Citations were screened, data extracted, and study quality assessed according to Cochrane guidelines for systematic reviews, including risk of bias assessment. Statistical synthesis of the included study results was not appropriate; results were summarized in a nonstatistical manner using the vote-counting method to estimate beneficial versus harmful effects.
UNASSIGNED: Of 679 citations, 15 studies met the inclusion criteria. Six studies addressed shared decision-making in the management of pain, spasms, neurogenic bladder, fatigue, gait disorder, and/or balance issues, and nine studies addressed physical symptoms in general. One study was a randomized controlled trial; most studies were observational studies. All study results and study author conclusions indicated that shared decision-making is important to the effective management of physical MS symptoms. No study results suggested that shared decision-making was harmful or delayed the management of physical MS symptoms.
UNASSIGNED: Reported results consistently indicate that shared decision-making is important in effective MS symptomatic care. Further rigorous randomized controlled trials are warranted to investigate the effectiveness of shared decision-making associated with MS physical symptomatic care.
UNASSIGNED: PROSPERO: CRD42023396270.
Shared decision-making among people with Multiple Sclerosis (MS) and their healthcare providers in the management of the physical symptoms of MS. Shared decision-making is suggested to be a key mechanism in promoting optimal symptomatic care related to Multiple Sclerosis (MS). Shared decision-making is mostly done and studied in relation to choosing therapies that may slow disease progression but not usually for symptomatic care. There are a few studies highlighting the effect of utilizing shared decision-making in symptomatic care of MS. We performed this study to identify all the published data about using shared decision-making in symptomatic care in MS to answer the research question: What is the evidence on shared decision-making in managing physical MS symptoms? We performed a systematic search for all the related published study results in four large literature databases. We found 15 studies on the use of shared decision-making in the management of MS-related symptoms. We synthesized the study results relating to the use of shared decision-making in symptomatic care of MS. The studies used several different designs and included a wide range of study rigor and quality. The results of our systematic review are: All the studies were consistent in their conclusions that shared decision-making is important for effective MS-related symptom management.Several studies found that symptomatic care is of the highest priority to people with MS, but not often a priority to their health care providers.The use of a shared decision-making model can promote discussion of symptoms in clinical consultations and align the goals of people with MS and their health care providers.Education of people with MS regarding their symptoms and available treatments will promote effective shared decision-making discussions. The available evidence supports that the use of shared decision-making is beneficial to the management of physical symptoms of MS. Further studies using a randomized controlled study design are required to establish the degree of benefit of utilizing shared decision-making associated with MS symptomatic care.
摘要：
■多发性硬化症（MS）是一种慢性自身免疫性炎症，脱髓鞘,和影响年轻人的神经退行性疾病。MS患者对参与身体症状管理和决策非常感兴趣，但通常不积极参与症状管理讨论。研究共享决策在身体MS症状管理中的益处的研究很少。
■本研究旨在确定和综合在物理MS症状管理中使用共享决策的证据。
■本研究是对已发表的关于在物理MS症状管理中使用共享决策的证据的系统回顾。
■MEDLINE,CINAHL,EMBASE,和CENTRAL数据库在2021年4月、2022年6月和2023年4月2日进行了搜索，在MS躯体症状管理中共同决策的同行评审研究。对引文进行了筛选，提取的数据，并根据Cochrane系统评价指南评估研究质量，包括偏见风险评估。纳入研究结果的统计综合是不合适的；结果以非统计方式使用投票计数方法进行汇总，以估计有益与有害的影响。
■在679篇引文中，15项研究符合纳入标准。六项研究涉及疼痛管理中的共同决策，痉挛,神经源性膀胱，疲劳,步态障碍,和/或平衡问题，和九项研究解决了一般的身体症状。一项研究是随机对照试验；大多数研究是观察性研究。所有研究结果和研究作者的结论都表明，共同决策对于有效管理MS症状很重要。没有研究结果表明，共同决策是有害的或延迟管理的物理MS症状。
■报告的结果一致表明，共同决策在有效的MS症状护理中很重要。需要进一步严格的随机对照试验来研究与MS身体症状护理相关的共同决策的有效性。
■PROSPERO：CRD42023396270。
多发性硬化症（MS）患者及其医疗保健提供者在管理MS的身体症状方面的共同决策。建议共享决策是促进与多发性硬化症（MS）相关的最佳症状护理的关键机制。共享决策主要是在选择可能减缓疾病进展但通常不是对症治疗的疗法方面进行研究。有一些研究强调了在MS的症状护理中利用共同决策的效果。我们进行了这项研究，以确定有关在MS症状护理中使用共享决策的所有已发表数据，以回答研究问题：在管理MS症状中共享决策的证据是什么？我们在四个大型文献数据库中对所有相关已发表研究结果进行了系统搜索。我们发现了15项关于在MS相关症状管理中使用共享决策的研究。我们综合了与在MS的症状护理中使用共享决策有关的研究结果。这些研究使用了几种不同的设计，包括广泛的研究严谨性和质量。我们系统评价的结果是：所有研究的结论都一致，即共同决策对于有效的MS相关症状管理很重要。几项研究发现，症状护理是MS患者的首要任务，但往往不是优先考虑他们的医疗保健提供者。使用共享决策模型可以促进临床咨询中症状的讨论，并使人们与MS及其医疗保健提供者的目标保持一致。对MS患者进行有关其症状和可用治疗的教育将促进有效的共享决策讨论。现有证据支持使用共同决策有利于MS的身体症状的管理。需要使用随机对照研究设计进行进一步研究，以确定利用与MS症状护理相关的共同决策的益处程度。
■本研究旨在确定和综合在物理MS症状管理中使用共享决策的证据。
■本研究是对已发表的关于在物理MS症状管理中使用共享决策的证据的系统回顾。
■MEDLINE,CINAHL,EMBASE,和CENTRAL数据库在2021年4月、2022年6月和2023年4月2日进行了搜索，在MS躯体症状管理中共同决策的同行评审研究。对引文进行了筛选，提取的数据，并根据Cochrane系统评价指南评估研究质量，包括偏见风险评估。纳入研究结果的统计综合是不合适的；结果以非统计方式使用投票计数方法进行汇总，以估计有益与有害的影响。
■在679篇引文中，15项研究符合纳入标准。六项研究涉及疼痛管理中的共同决策，痉挛,神经源性膀胱，疲劳,步态障碍,和/或平衡问题，和九项研究解决了一般的身体症状。一项研究是随机对照试验；大多数研究是观察性研究。所有研究结果和研究作者的结论都表明，共同决策对于有效管理MS症状很重要。没有研究结果表明，共同决策是有害的或延迟管理的物理MS症状。
■报告的结果一致表明，共同决策在有效的MS症状护理中很重要。需要进一步严格的随机对照试验来研究与MS身体症状护理相关的共同决策的有效性。
■PROSPERO：CRD42023396270。
多发性硬化症（MS）患者及其医疗保健提供者在管理MS的身体症状方面的共同决策。建议共享决策是促进与多发性硬化症（MS）相关的最佳症状护理的关键机制。共享决策主要是在选择可能减缓疾病进展但通常不是对症治疗的疗法方面进行研究。有一些研究强调了在MS的症状护理中利用共同决策的效果。我们进行了这项研究，以确定有关在MS症状护理中使用共享决策的所有已发表数据，以回答研究问题：在管理MS症状中共享决策的证据是什么？我们在四个大型文献数据库中对所有相关已发表研究结果进行了系统搜索。我们发现了15项关于在MS相关症状管理中使用共享决策的研究。我们综合了与在MS的症状护理中使用共享决策有关的研究结果。这些研究使用了几种不同的设计，包括广泛的研究严谨性和质量。我们系统评价的结果是：所有研究的结论都一致，即共同决策对于有效的MS相关症状管理很重要。几项研究发现，症状护理是MS患者的首要任务，但往往不是优先考虑他们的医疗保健提供者。使用共享决策模型可以促进临床咨询中症状的讨论，并使人们与MS及其医疗保健提供者的目标保持一致。对MS患者进行有关其症状和可用治疗的教育将促进有效的共享决策讨论。现有证据支持使用共同决策有利于MS的身体症状的管理。需要使用随机对照研究设计进行进一步研究，以确定利用与MS症状护理相关的共同决策的益处程度。
