ICU患者替代决策者共享决策干预的范围综述.pdfVIP

:124JournalofNursingScienceAug.2025Vol.40No.16

ICU患者替代决策者共享决策干预的范围综述

王思淼，李君²，张晓辉”,徐伟4，李依，杨昕怡，李育蔚，尚雪莹3

摘要：目的对ICU患者替代决策者共享决策于预研究进行范围综述，明确干预要素，为开展相关研究及应用提供参考。方法以

JBI范围综述方法学为指导，系统检索PubMed中国生物医学文献数据库、

理论、自我效能理论、促进感知模型等为理论依据进行干预；15项研究的干预方法包括决策辅助工具、沟通促进者、多组分家庭支

持措施、护士参与家庭会议及书面沟通；干预时机多为住院期间；结局指标包括心理情绪、决策结局、医疗服务质量与体验、患者结

局指标等；共享决策干预可改善ICU患者替代决策者的决策结局，提升医疗服务质量与体验。结论ICU共享决策干预研究尚处

于发展阶段，其积极影响已得到初步验证。未来研究应重点关注理论框架的整合、干预时机的选择、长期干预效果的评估以及本

土化实践创新等方面的拓展。

关键词：ICU；替代决策者；共享决策；决策辅助；决策冲突；范围综述；循证护理

中图分类号：R471D0I：10.3870/j.issn.1001-4152.2025.16.124

Ascopingreviewofshareddecision-makinginterventionsforsurrogatedecision-

makersofICUpatients

SWangSimiao,LiJun,ZhanagXiaohui,XuWei,LiYi,YangXinyi,LiYu-

wei,ShangXueying.SchoolofNursing,HenanUniversityofScienceandTechnology,Luoyang4710o0,China

Abstract:ObjectiveToconductascopingreviewofshareddecision-making(SDM)interventionsforsurrogatedecision-makersof

ICUpatients,toidentifycoreinterventioncomponents,aimingtoinformfutureresearchandclinicalpractice.MethodsGuidedby

theJoannaBriggsInstitute(JBI)scopingreviewmethodology,asystematicsearchwasperformedinPubMed,Embase,Cochrane

Library,WebofScience,CINAHL,ChinaBiomedicalLiteratureDatabase,CNKI,andWanfang,fromdatabaseinceptiontoDe-

cember20,2024.Studycharacteristicsandinterventionswerethematicallysynthesized.ResultsFifteenstudies(13RCTs,2

mixed-methodsstudies)wereincluded.NinestudiesutilizedestablishedframeworksincludingOttawaDecisionSupportFrame-

work,Cognitive-EmotionalDecisionTheory,FamilySystemsTheory,SocialCognitiveTheory,Self-efficacyTheory,andSenseof

CoherenceModel.Interventiontypesincludeddecisionaids,communicationfacilitators,multimodalfamilysupport,