Abstract：
OBJECTIVE: Older adults experiencing neurocognitive disease (NCD) contend with complex care often characterized by high emotional strain. Mitigating complex care with decision support tools can clarify options. When used in conjunction with the practice of Shared Decision Making (SDM) these tools can improve satisfaction and confidence in treatment. Use of these tools for cognitive health has increased but more is needed to understand how these tools incorporate social needs into treatment plans.
METHODS: We conducted an environmental scan using a MEDLINE informed search strategy and feedback from an expert steering committee to characterize current tools and approaches for engaging older adults experiencing NCD. We assessed their application and development, incorporation of social determinants, goals or preferences, and inclusion of caregivers in their design.
RESULTS: We identified eleven articles, seven of which show that SDM helps guide tool development and that all tools center on clinical decision making. Types of tools varied by clinical site and those differences reflected patient need. A collective value across tools was their use to forge meaningful conversations. No tool appeared designed with the explicit goal to elicit patient social needs or incorporate non-clinical strategies into treatment plans.
CONCLUSIONS: Several challenges and opportunities that centered on strategies to engage patients in the design and testing of tools that support conversations with clinicians about cognitive health. Future work should focus on building and testing adaptable tools that support patient and family social care needs beyond clinical care settings.
METHODS: We conducted an environmental scan using a MEDLINE informed search strategy and feedback from an expert steering committee to characterize current tools and approaches for engaging older adults experiencing NCD. We assessed their application and development, incorporation of social determinants, goals or preferences, and inclusion of caregivers in their design.
RESULTS: We identified eleven articles, seven of which show that SDM helps guide tool development and that all tools center on clinical decision making. Types of tools varied by clinical site and those differences reflected patient need. A collective value across tools was their use to forge meaningful conversations. No tool appeared designed with the explicit goal to elicit patient social needs or incorporate non-clinical strategies into treatment plans.
CONCLUSIONS: Several challenges and opportunities that centered on strategies to engage patients in the design and testing of tools that support conversations with clinicians about cognitive health. Future work should focus on building and testing adaptable tools that support patient and family social care needs beyond clinical care settings.
摘要：
目标：经历神经认知疾病（NCD）的老年人与通常以高度情绪紧张为特征的复杂护理相抗衡。使用决策支持工具减轻复杂的护理可以澄清各种选择。当与共享决策（SDM）实践结合使用时，这些工具可以提高治疗的满意度和信心。这些工具在认知健康方面的使用有所增加，但需要更多的了解这些工具如何将社会需求纳入治疗计划。
方法：我们使用MEDLINE知情搜索策略和专家指导委员会的反馈进行了环境扫描，以描述当前参与非传染性疾病老年人的工具和方法。我们评估了它们的应用和发展，纳入社会决定因素，目标或偏好，并将护理人员纳入他们的设计中。
结果：我们确定了11篇文章，其中7项显示SDM有助于指导工具开发，所有工具均以临床决策为中心。工具的类型因临床部位而异，这些差异反映了患者的需求。跨工具的集体价值是它们用于进行有意义的对话。没有任何工具被设计为明确的目标来引起患者的社会需求或将非临床策略纳入治疗计划。
结论：几个挑战和机遇集中在使患者参与设计和测试工具的策略上，这些工具支持与临床医生就认知健康进行对话。未来的工作应该集中在构建和测试适应的工具，以支持超出临床护理环境的患者和家庭社会护理需求。
方法：我们使用MEDLINE知情搜索策略和专家指导委员会的反馈进行了环境扫描，以描述当前参与非传染性疾病老年人的工具和方法。我们评估了它们的应用和发展，纳入社会决定因素，目标或偏好，并将护理人员纳入他们的设计中。
结果：我们确定了11篇文章，其中7项显示SDM有助于指导工具开发，所有工具均以临床决策为中心。工具的类型因临床部位而异，这些差异反映了患者的需求。跨工具的集体价值是它们用于进行有意义的对话。没有任何工具被设计为明确的目标来引起患者的社会需求或将非临床策略纳入治疗计划。
结论：几个挑战和机遇集中在使患者参与设计和测试工具的策略上，这些工具支持与临床医生就认知健康进行对话。未来的工作应该集中在构建和测试适应的工具，以支持超出临床护理环境的患者和家庭社会护理需求。
