A qualitative systematic review of internal and external influences on shared decision-making in all health care settings.

Abstract

Review question/objective The objective of this review is to identify and synthesize the best available evidence related to the meaningfulness of internal and external influences on shared-decision making for adult patients and health care providers in all health care settings. The specific questions to be answered are: •What are the internal and external influences on shared decision making from the perspective of adult patients in all health care settings? •What are the internal and external influences on shared decision making from the perspective of health care providers caring for adult patients in all health care settings? Inclusion criteria Types of participants This review will consider studies that include adult patients (18 year of age or older) of all races and ethnicities regardless of health status or condition and health care providers, including but not limited to nurses, advanced practice nurses, and physicians, caring for such patients who are involved in a shared decision-making process. Phenomena of interest This review will consider studies that investigate the internal and external influences on shared decision-making including but not limited to communication, trust, mutual respect, honesty, time, continuity, consistency, commitment, autonomy, empowerment, age, education, socio-economic status, culture, and diagnosis for adult patients and health care providers in all health care settings, where shared decision-making is defined as a joint process characterized by sharing and negotiating between the patient and health care provider that results in a mutually agreed upon decision. Types of studies This review will consider interpretive studies that draw on the internal and external influences on shared decision making on adult patients and health care providers including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.