关键词: 决策辅助工具, 失智症, 家庭照护者, 代理决策, 范围综述, 护理

Abstract:

Objective To conduct a scoping review of the application of decision aid （DA） in the nursing decision making of patients with dementia，identify the elements and application status of DA intervention，and provide references for the practice of DA and related research. Methods Pubmed，CINAHL，Cochrane Library，Embase，PsycINFO，CNKI，Wanfang database，CBM and VIP database were searched. The time limit for the search was from the establishment of databases until July 31，2023. The included literature was summarized and analyzed. Results A total of 19 articles were included，and topics on DA included advance care planning，care models，feeding choices，daily living，and goal of care decisions. The content elements of DA include providing information related to the patient’s physical condition and decision-making topics，providing alternative decision options and describing advantages and disadvantages，clarifying values and treatment preferences，and interactive decision support communication with peers and professionals. The outcome measures include decision process indicators，decision quality indicators and feasibility evaluation. Conclusion DA can significantly reduce the level of decision conflict between patients and caregivers，improve the quality of decision-making，with good feasibility. More high-quality randomized controlled studies with homogeneous interventions are needed in the future，in order to improve the effect evaluation index，and explore the best intervention time of DA，strengthen the professional support in the decision-making process，and accelerate the development of local relevant DA according to the specific practice situation in China，so as to provide high-quality decision support for dementia patients and caregivers.

Key words: Decision Aids, Dementia, Family Caregivers, Proxy Decision-Making, Scoping Review, Nursing Care