PDF(Pubmed)
Abstract：
OBJECTIVE: The objective of this systematic review was to explore the evidence regarding shared decision-making (SDM) in the management of pulmonary nodules.
METHODS: Systematic review of quantitative and qualitative studies.
METHODS: Studies published in English or Chinese up to April 2022 were extracted from nine databases: PubMed, PsycINFO, EMBASE, Cochrane Library, Web of Science and CINAHL, China National Knowledge Infrastructure, Wanfang Data and SinoMed Data.
METHODS: Studies were eligible if patients or healthcare providers are faced with pulmonary nodule management options or the interventions or experiences were focused on the patient-healthcare provider relationship or health education to make, increase or support shared decisions. All types of studies were included, including quantitative and qualitative studies. Grey literature and literature that had not been peer reviewed were excluded. Poster abstracts and non-empirical publications such as editorials, letters, opinion papers and review articles were excluded.
METHODS: Two reviewers independently screened abstracts and full texts, assessed quality using Joanna Briggs Institute\'s critical appraisal tools, and extracted data from included studies. Thematic syntheses were used to identify prominent themes emerging from the data.
RESULTS: A total of 12 studies met the inclusion criteria, 11 of which were conducted in USA. These included six qualitative studies and six quantitative studies (including both survey and quasi-experimental designs). Three major themes with specific subthemes emerged: (1) Opportunity (uncertainty in the diagnosis and treatment of pulmonary nodules, willingness to participate in decision-making); (2) Ability (patient\'s lack of knowledge, physician\'s experience); and (3) Different worldview (misconception, distress among patients, preference for diagnosis and treatment).
CONCLUSIONS: Uncertainty in the management of pulmonary nodules is the opportunity to implement SDM. Patients\' lack of knowledge, distress, and misunderstandings between healthcare providers and patients are both the main obstacles and the causes of the application of SDM.
METHODS: Systematic review of quantitative and qualitative studies.
METHODS: Studies published in English or Chinese up to April 2022 were extracted from nine databases: PubMed, PsycINFO, EMBASE, Cochrane Library, Web of Science and CINAHL, China National Knowledge Infrastructure, Wanfang Data and SinoMed Data.
METHODS: Studies were eligible if patients or healthcare providers are faced with pulmonary nodule management options or the interventions or experiences were focused on the patient-healthcare provider relationship or health education to make, increase or support shared decisions. All types of studies were included, including quantitative and qualitative studies. Grey literature and literature that had not been peer reviewed were excluded. Poster abstracts and non-empirical publications such as editorials, letters, opinion papers and review articles were excluded.
METHODS: Two reviewers independently screened abstracts and full texts, assessed quality using Joanna Briggs Institute\'s critical appraisal tools, and extracted data from included studies. Thematic syntheses were used to identify prominent themes emerging from the data.
RESULTS: A total of 12 studies met the inclusion criteria, 11 of which were conducted in USA. These included six qualitative studies and six quantitative studies (including both survey and quasi-experimental designs). Three major themes with specific subthemes emerged: (1) Opportunity (uncertainty in the diagnosis and treatment of pulmonary nodules, willingness to participate in decision-making); (2) Ability (patient\'s lack of knowledge, physician\'s experience); and (3) Different worldview (misconception, distress among patients, preference for diagnosis and treatment).
CONCLUSIONS: Uncertainty in the management of pulmonary nodules is the opportunity to implement SDM. Patients\' lack of knowledge, distress, and misunderstandings between healthcare providers and patients are both the main obstacles and the causes of the application of SDM.
摘要：
目的：本系统评价的目的是探索肺结节管理中关于共同决策（SDM）的证据。
方法：定量和定性研究的系统评价。
方法：截至2022年4月以英文或中文发表的研究来自9个数据库：PubMed，PsycINFO,EMBASE,科克伦图书馆,WebofScience和CINAHL,中国国家知识基础设施，万方数据和中国计量数据。
方法：如果患者或医疗保健提供者面临肺结节管理选择，或者干预措施或经验侧重于患者与医疗保健提供者的关系或健康教育，增加或支持共同决策。所有类型的研究都包括在内，包括定量和定性研究。灰色文献和未经同行评审的文献被排除。海报摘要和非实证出版物，如社论，信件,意见书和评论文章被排除在外。
方法：两名评审员独立筛选摘要和全文，使用乔安娜·布里格斯研究所的关键评估工具评估质量，并从纳入的研究中提取数据。专题综合用于确定数据中出现的突出主题。
结果：共有12项研究符合纳入标准，其中11起是在美国进行的。其中包括六项定性研究和六项定量研究（包括调查和准实验设计）。出现了具有特定子主题的三个主要主题：（1）机会（肺结节的诊断和治疗中的不确定性，参与决策的意愿)；(2)能力(患者缺乏知识，医生的经验)；和(3)不同的世界观(误解，患者中的痛苦，对诊断和治疗的偏好)。
结论：肺结节管理的不确定性是实施SDM的机会。病人缺乏知识，苦恼,医疗服务提供者和患者之间的误解是应用SDM的主要障碍和原因。
方法：定量和定性研究的系统评价。
方法：截至2022年4月以英文或中文发表的研究来自9个数据库：PubMed，PsycINFO,EMBASE,科克伦图书馆,WebofScience和CINAHL,中国国家知识基础设施，万方数据和中国计量数据。
方法：如果患者或医疗保健提供者面临肺结节管理选择，或者干预措施或经验侧重于患者与医疗保健提供者的关系或健康教育，增加或支持共同决策。所有类型的研究都包括在内，包括定量和定性研究。灰色文献和未经同行评审的文献被排除。海报摘要和非实证出版物，如社论，信件,意见书和评论文章被排除在外。
方法：两名评审员独立筛选摘要和全文，使用乔安娜·布里格斯研究所的关键评估工具评估质量，并从纳入的研究中提取数据。专题综合用于确定数据中出现的突出主题。
结果：共有12项研究符合纳入标准，其中11起是在美国进行的。其中包括六项定性研究和六项定量研究（包括调查和准实验设计）。出现了具有特定子主题的三个主要主题：（1）机会（肺结节的诊断和治疗中的不确定性，参与决策的意愿)；(2)能力(患者缺乏知识，医生的经验)；和(3)不同的世界观(误解，患者中的痛苦，对诊断和治疗的偏好)。
结论：肺结节管理的不确定性是实施SDM的机会。病人缺乏知识，苦恼,医疗服务提供者和患者之间的误解是应用SDM的主要障碍和原因。
