Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
There is an increase in published studies relevant to the development of patient version of guidelines (PVGs). We reviewed, summarised and analysed the current developments in this field, with the aim of informing domestic scholars of the factors to consider when developing quality PVGs. We proposed three recommendations: (1) the concept of patient guidelines needs to be better defined; (2) a platform for the dissemination of PVGs should be established to support their implementation; and (3) a standardised PVGs development methodology should be developed to ensure the quality of the PVGs.
Objective To clarify the views of healthcare providers on the current vascular access shared decision-making model under the daytime chemotherapy mode, and to determine improvement measures to promote the conventional implementation of the daytime chemotherapy vascular access shared decision-making model. Methods Based on the SWOT model, an interview outline was developed. Using purposive sampling method, 7 doctors and 6 intravenous therapy nurses working at Tianjin Medical University Cancer Institute & Hospital from April to June 2023 were selected for semi-structured interviews, and content analysis method was used for data analysis. Results Four themes were extracted for internal advantages: alleviating the pressure of diagnosis and treatment and decision-making for doctors, ability and willingness of specialized intravenous therapy nurses to implement, promoting the rational selection of vascular pathways, enhancing the recognition of vascular pathways in daytime chemotherapy patients, and enhancing communication stickiness between nurses and patients. Four themes were extracted for internal weaknesses: increased workload, impractical decision support tools, unsmooth implementation processes, and incomplete informatization. Three themes were extracted for external opportunities: national policy support, willingness of daytime chemotherapy patients to participate in decision-making, and sufficient evidence-based evidence. Three themes were extracted for external threats: poor communication between healthcare providers under daytime chemotherapy mode, cognitive differences related to intravenous therapy among healthcare providers, and insufficient confidence in nurse leadership. Conclusions The vascular pathway shared decision-making led by intravenous therapy nurses has certain advantages in the daytime chemotherapy mode. In the future, we should seize existing opportunities, avoid our own weaknesses, face external threats, and develop a standardized vascular access shared decision-making model led by intravenous therapy nurses under the daytime chemotherapy mode, promoting the best evidence-based practice for vascular access decision-making during daytime chemotherapy.
Systematic review (SR) and meta-analysis, as the highest level of evidence-based medicine, are an indispensable part of guiding medical staff to make medical decisions. At the same time, the status of patients as shared decision-making is rising. At present, the results of SR and meta-analysis are mainly presented in the form of effect (relative risk or mean difference) and forest plot. The expression is not intuitive or professional. The process of evidence-based evidence guiding clinical decision-making lags behind, which cannot meet the needs of rapid decision-making. With the continuous progress in artificial intelligence and big data analysis tools, researchers have attempted to introduce visual presentations to improve the timeliness of clinical decision-making. Through the interpretation of the outcomes of SR and meta-analysis, this paper presents different visualization results from the perspective of patients and clinical decision-makers, which not only helps the majority of people without medical background understand clinical evidence more intuitively and participate in the process of clinical decision-making, but also helps improve residents' health literacy, promotes the dissemination and sharing of knowledge, and provides references for further promoting the technology of automatic decision-making system.