METHODS: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz\'s value theory to define values in SDM and to investigate value relations.
RESULTS: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals\' (HCPs) and patients\' skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients\' autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism].
CONCLUSIONS: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients\' Self-Direction.
CONCLUSIONS: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients\' values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.
方法:我们包括了以前确定的SDM模型(n=40)和15个其他模型。使用主题分析,我们使用Schwartz的价值理论对数据进行编码,以定义SDM中的值并研究值关系。
结果:我们确定并定义了八个值,并根据它们的关系开发了三个主题:共享控制,一个安全和支持的环境,和为患者量身定制的决定。我们构建了基于价值关系和主题的价值结构:医疗保健专业人员(HCP)和患者技能的相互作用[成就],支持病人[仁慈],HCP和患者[安全]之间的良好关系都有助于患者的自主性[自我指导]。这些值使HCP和患者之间的关系更加平衡,并制定了量身定制的决策[普遍主义]。
结论:SDM可以通过值的相互作用来实现。仁慈和安全的价值观值得更明确的关注,并可能特别增加脆弱患者的自我指导。
结论:这种值结构可以将SDM的基础值与特定人群的值进行比较,促进将患者价值观纳入治疗决策。它还可以为SDM措施的发展提供信息,干预措施,教育计划,和HCPs练习时。