患者决策辅助工具在终末期肾脏病患者治疗方式选择中应用效果的系统评价  

Efficacy of PDA in the selection of treatment modalities for patients with end-stage renal disease:a systematic review

作　　者：姚舞凤 杨丽平 秦子岚[1,2] 李侃 陈红琢[3] 陈洁[3] 刘天喜[3] YAO Wufeng;YANG Liping;QIN Zilan;LI Kan;CHEN Hongzhuo;CHEN Jie;LIU Tianxi(School of Nursing,Lanzhou University,Lanzhou 730000,P.R.China;Department of General Surgery,the First Hospital of Lanzhou University,Lanzhou 730000,P.R.China;Blood Purification Center,the First Hospital of Lanzhou University,Lanzhou 730000,P.R.China)

机构地区：[1]兰州大学护理学院,兰州730000 [2]兰州大学第一医院普外科,兰州730000 [3]兰州大学第一医院血液净化中心,兰州730000

出　　处：《中国循证医学杂志》2024年第1期56-60,共5页Chinese Journal of Evidence-based Medicine

基　　金：甘肃省自然科学基金项目(编号:21JR7RA368);兰大一院院内基金资助项目(编号:ldyyyn2022-34)。

摘　　要：目的系统评价患者决策辅助工具(PDA)在终末期肾脏病患者治疗方式选择中的应用效果。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、CBM、CNKI和VIP数据库,搜集与研究目的相关的随机对照试验(RCT),检索时限均为建库至2023年3月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,进行定量和定性分析。结果共纳入8个RCT,包括1544例患者。系统评价结果显示,PDA有助于提高患者知识水平,降低患者决策冲突水平,改变患者决策讨论率。结论当前证据显示,终末期肾脏病治疗方式决策中使用PDA可提高患者决策知识,降低决策冲突,但对决策结局性指标的干预效果具有一定局限性。Objective To systematically review the efficacy of patient decision aids(PDA)in the selection of treatment modalities for end-stage renal diseases.Methods The PubMed,Web of Science,Embase,Cochrane Library,CBM,CNKI and VIP databases were electronically searched to collect randomized controlled trials(RCTs)related to the objectives from inception to March 2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Quantitative and qualitative analysis was then performed.Results A total of 8 RCTs involving 1544 patients were included.The systematic review results showed that PDA could improve patient knowledge,reduce patient decision-making conflict,and change patient decision-making discussion rate.Conclusion Current evidence shows that patients with end-stage renal diseases can benefit from PDA to improve their decision-making knowledge and reduce conflicts in their decisions,but its impact on the decision-making outcome index is limited.

关 键 词：终末期肾脏病 患者决策辅助工具 干预效果 系统评价 随机对照试验 

分 类 号：R692.5[医药卫生—泌尿科学]