PDF(Pubmed)
Abstract：
BACKGROUND: Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions.
METHODS: An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies\' contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews.
RESULTS: Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance (\"Indigenous-oriented\")(n = 6); and those based on Western academic knowledge and governance (\"Western-oriented\")(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building.
CONCLUSIONS: There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed.
METHODS: An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies\' contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews.
RESULTS: Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance (\"Indigenous-oriented\")(n = 6); and those based on Western academic knowledge and governance (\"Western-oriented\")(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building.
CONCLUSIONS: There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed.
摘要：
背景：共享决策促进了患者和医疗保健提供者之间的合作，以做出明智的健康决策。我们的审查确定了支持土著人民做出健康决定的干预措施。目标是综合证据并确定影响共享决策干预措施使用的因素。
方法：由服务提供商和学术研究人员组成的因纽特人和非因纽特人团队使用集成的知识翻译方法和框架综合来共同进行系统综述。我们开发了一个概念框架来组织和描述共同的决策过程，并指导确定描述干预措施以支持土著人民做出健康决策的研究。我们从2012年9月至2022年3月对电子数据库进行了全面搜索，并进行了灰色文献检索。对两名独立的团队成员进行了筛选，并对质量进行了评估，其中包括有关研究对共同决策和土著自决的贡献的优势和相关性的研究。对调查结果进行了与概念框架相关的描述性分析，并使用准则进行报告，以确保报告的透明度和完整性，并进行面向公平的系统审查。
结果：在筛选的5068篇引文中，10份出版物中报道的9项研究符合纳入条件.我们将这些研究分为以下几类：包括土著知识和治理（\“面向土著”）（n=6）；以及基于西方学术知识和治理（\“面向西方”）（n=3）。这些研究被发现对共同决策和自决的贡献具有不同的质量，以本土为导向的研究总体上比西方为导向的研究质量更高。四个主题反映在更新的概念框架中：1)共享决策发生影响决策机会的地方，2)对参与共享决策过程的医疗保健提供者的特征知之甚少，3)社区是共同决策的伙伴，4)共享决策过程涉及建立信任。
结论：很少有研究报告和评估与土著人民共同的决策干预措施。总的来说,面向土著的研究力求使卫生保健系统更适合土著人民的共同决策，而面向西方的研究将共同决策与医疗保健环境分开。需要进一步研究以解决方案为重点并支持土著自决。
方法：由服务提供商和学术研究人员组成的因纽特人和非因纽特人团队使用集成的知识翻译方法和框架综合来共同进行系统综述。我们开发了一个概念框架来组织和描述共同的决策过程，并指导确定描述干预措施以支持土著人民做出健康决策的研究。我们从2012年9月至2022年3月对电子数据库进行了全面搜索，并进行了灰色文献检索。对两名独立的团队成员进行了筛选，并对质量进行了评估，其中包括有关研究对共同决策和土著自决的贡献的优势和相关性的研究。对调查结果进行了与概念框架相关的描述性分析，并使用准则进行报告，以确保报告的透明度和完整性，并进行面向公平的系统审查。
结果：在筛选的5068篇引文中，10份出版物中报道的9项研究符合纳入条件.我们将这些研究分为以下几类：包括土著知识和治理（\“面向土著”）（n=6）；以及基于西方学术知识和治理（\“面向西方”）（n=3）。这些研究被发现对共同决策和自决的贡献具有不同的质量，以本土为导向的研究总体上比西方为导向的研究质量更高。四个主题反映在更新的概念框架中：1)共享决策发生影响决策机会的地方，2)对参与共享决策过程的医疗保健提供者的特征知之甚少，3)社区是共同决策的伙伴，4)共享决策过程涉及建立信任。
结论：很少有研究报告和评估与土著人民共同的决策干预措施。总的来说,面向土著的研究力求使卫生保健系统更适合土著人民的共同决策，而面向西方的研究将共同决策与医疗保健环境分开。需要进一步研究以解决方案为重点并支持土著自决。
