目的 整合脑卒中患者-医护人员双视角下共享决策(shared decision-making,SDM)体验的质性研究,为临床开展以患者为中心的共享决策提供参考。方法 检索Pubmed、Web of Science、Embase、CINAHL、Cochrane Library、中国知网、维普数据库、万方数据库和中国生物医学文献数据库,收集脑卒中患者-医护人员双视角下SDM体验的质性研究,检索时间为各数据库建库至2026年2月,运用汇集性整合法进行跨研究整合。结果 共纳入12篇文献,提炼出24个研究结果,归纳出10个新类别,形成3个整合结果,即参与SDM的多元互动特征;参与SDM面临的多重障碍;参与SDM的需求和互动策略。结论 SDM实践中脑卒中患者与医护人员互动体验复杂且面临多重障碍。未来实践需构建动态匹配的SDM模式,提供针对性决策支持,组建SDM跨专业团队,以推动SDM的有效实施。

Objective To integrate qualitative studies on shared decision-making (SDM) experience from the dual perspective of stroke patients and medical staff,and to provide references for carrying out patient-centered shared decision-making in clinical practice.Methods Databases namely PubMed,Web of Science,Embase,CINAHL,Cochrane Library,CNKI,VIP,Wanfang Database and China Biomedical Literature Database were systematically searched.Qualitative studies on SDM experience from the dual perspective of stroke patients and medical staff were retrieved from the inceptions to February 2026.The integrative meta-synthesis method was adopted for cross-study integration.Results A total of 12 literatures was included,from which 24 findings were extracted and summarized into 10 categories,forming 3 integrated results namely multiple interactive characteristics of participating in SDM,multiple barriers to SDM participation,and demands and interactive strategies for SDM participation.Conclusions Stroke patients and medical staff have complex interactive experiences and face multiple barriers in the practice of SDM.Future clinical practice should construct a dynamically matched SDM model,provide targeted decision support,and set up an interdisciplinary SDM team to promote the effective implementation of shared decision-making.

R473.74