Shared decision making in older patients with symptomatic severe aortic stenosis: a systematic review.

Autor:	van Beek-Peeters JJAM; Department of Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands jvanbeek1@amphia.nl., van Noort EHM; Department of Geriatrics, Amphia Hospital, Breda, The Netherlands., Faes MC; Department of Geriatrics, Amphia Hospital, Breda, The Netherlands., de Vos AJBM; Nursing Council, Amphia Hospital, Breda, The Netherlands., van Geldorp MWA; Department of Cardiothoracic Surgery, Amphia Hospital, Breda, The Netherlands., Minkman MMN; TIAS, School for Business and Society, Tilburg University, Tilburg, The Netherlands.; Vilans, Centre of Expertise for Long-term Care, Utrecht, The Netherlands., van der Meer NJM; TIAS, School for Business and Society, Tilburg University, Tilburg, The Netherlands.; Department of Anesthesiology, Amphia Hospital, Breda, The Netherlands.
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2020 May; Vol. 106 (9), pp. 647-655. Date of Electronic Publication: 2020 Jan 30.
DOI:	10.1136/heartjnl-2019-316055
Abstrakt:	This review provides an overview of the status of shared decision making (SDM) in older patients regarding treatment of symptomatic severe aortic stenosis (SSAS). The databases Embase, Medline Ovid, Cinahl and Cochrane Dare were searched for relevant studies from January 2002 to May 2018 regarding perspectives of professionals, patients and caregivers; aspects of decision making; type of decision making; application of the six domains of SDM; barriers to and facilitators of SDM. The systematic search yielded 1842 articles, 15 studies were included. Experiences of professionals and informal caregivers with SDM were scarcely found. Patient refusal was a frequently reported result of decision making, but often no insight was given into the decision process. Most studies investigated the 'decision' and 'option' domains of SDM, yet no study took all six domains into account. Problem analysis, personalised treatment aims, use of decision aids and integrating patient goals in decisions lacked in all studies. Barriers to and facilitators of SDM were 'individualised formal and informal information support' and 'patients' opportunity to use their own knowledge about their health condition and preferences for SDM'. In conclusion, SDM is not yet common practice in the decision making process of older patients with SSAS. Moreover, the six domains of SDM are not often applied in this process. More knowledge is needed about the implementation of SDM in the context of SSAS treatment and how to involve patients, professionals and informal caregivers. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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