Key elements and checklist of shared decisionmaking conversation on life-sustaining treatment in emergency:a multispecialty study from China  

作　　者：Shu Li Jing Xie Ziyi Chen Jie Yan Yuliang Zhao Yali Cong Bin Zhao Hua Zhang Hongxia Ge Qingbian Ma Ning Shen 

机构地区：[1]Department of Emergency Medicine,Peking University Third Hospital,Beijing 100191,China [2]Department of Infectious Diseases,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China [3]Department of Neurology,the First Affi liated Hospital,Sun Yat-sen University,Guangzhou 510080,China [4]Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China [5]Department of Nephrology,West China Hospital,West China School of Medicine,Chengdu 610041,China [6]Institute of Medical Humanities,School of Foundational Education,Peking University Health Science Center,Beijing 100191,China [7]Department of Emergency Medicine,Beijing Jishuitan Hospital,Fourth Medical College of Peking University,Beijing 100035,China [8]Clinical Epidemiology Research Center,Peking University Third Hospital,Beijing 100191,China [9]Department of Pulmonary and Critical Care Medicine,Peking University Third Hospital,Beijing 100191,China

出　　处：《World Journal of Emergency Medicine》2023年第5期380-385,共6页世界急诊医学杂志（英文）

基　　金：supported by the China Medical BoardOpen Competition Program(20-378);Peking University Third Hospital Fund for Returned Scholars(BYSYLXHG2020004);JX was supported by the Peking Union Medical College Fund for Informatization of Postgraduate Courses(2021YXX001);YLZ was supported by the Sichuan University Graduate Education Reform Project(GSSCU2021046)。

摘　　要：BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.

关 键 词：Shared decision-making Life-sustaining treatment EMERGENCY CHECKLIST 

分 类 号：R195[医药卫生—卫生统计学]