Enhancing shared and surrogate decision making for people living with dementia: A systematic review of the effectiveness of interventions
| Autor: | Rebecca R. Wassall, Catherine Exley, Andrew Geddis-Regan, Clare Abley, Linda Errington, Richard Thomson |
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| Rok vydání: | 2020 |
| Předmět: |
Advance care planning
Inclusion (disability rights) Decision Making shared decision making Psychological intervention Decision quality Review Article 03 medical and health sciences Advance Care Planning 0302 clinical medicine Nursing Health care medicine Decision aids proxy decision making Dementia Humans 030212 general & internal medicine Review Articles cognitive impairment lcsh:R5-920 business.industry lcsh:Public aspects of medicine 030503 health policy & services Public Health Environmental and Occupational Health lcsh:RA1-1270 Grey literature medicine.disease Caregivers lcsh:Medicine (General) 0305 other medical science business Psychology Delivery of Health Care |
| Zdroj: | Health Expectations : An International Journal of Public Participation in Health Care and Health Policy Health Expectations, Vol 24, Iss 1, Pp 19-32 (2021) |
| ISSN: | 1369-7625 |
| Popis: | Background Dementia can have a profound impact on decision making. People living with dementia (PLwD) often need to make decisions about health care, and, as dementia progresses, decisions may need to be made on their behalf. Specific interventions may support this process. Review question What interventions are effective in improving shared decision making or surrogate decision making on the health care of PLwD? Methods A narrative systematic review of existing literature was conducted. Seven databases, grey literature and key journals were searched. After exclusion by title, abstracts then full texts were reviewed collaboratively to manage any disagreements. Results Eight studies met the inclusion criteria. Two articles, including one RCT, evaluated decision aids regarding the use of enteral feeding in advanced dementia. Six further articles, including five RCTs, were found which evaluated the effectiveness of interventions supporting patients or carers with advance care planning. Conclusion Decision-making interventions typically consist of multiple components which aim to establish preferences for future health care. Advance care planning interventions supported aspects of the decision-making processes but their impact on decision quality was rarely evaluated. Interventions did not increase the concordance of decisions with a person's values. The decision-specific interventions are unlikely to produce benefit in other decision contexts. Patient involvement Two caregivers, a public stakeholder group and a carer group were consulted in the design of the wider study to which this review relates. Six PLwD refined the research questions addressed in this paper. |
| Databáze: | OpenAIRE |
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