Effectiveness of interventions to enhance shared decision‐making in wound care: A systematic review

Abstract

AbstractAimsTo explore the effectiveness of interventions to enhance patient participation in shared decision‐making in wound care and tissue viability.BackgroundCaring for people living with a wound is complex due to interaction between wound healing, symptoms, psychological wellbeing and treatment effectiveness. To respond to this complexity, there has been recent emphasis on the importance of delivering patient centred wound care and shared decision‐making to personalise health care. However, little is known about the effectiveness of existing interventions to support shared decision‐making in wound care.DesignSystematic review of interventional studies to enhance shared decision‐making in wound care or tissue viability. This was reported following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines 2020.MethodsInterventional primary research studies published in English up to January 2023 were included. Screening, data extraction and quality appraisal were undertaken independently by two authors.Data SourcesMedline, EMBASE, Cochrane Central Register of Controlled Trails (trials database), CINAHL, British Nursing Index (BNI), WorldCat (thesis database), Scopus and registries of ongoing studies (ISRCTN registry and clinicaltrials.gov).Results1063 abstracts were screened, and eight full‐text studies included. Findings indicate, interventions to support shared decision‐making are positively received. Goal or need setting components may assist knowledge transfer between patient and clinician, and could lower short term decisional conflict. However, generally findings within this study had very low certainty due to the inconsistencies in outcomes reported, and the variation and complexity of single and multiple interventions used.ConclusionsFuture research on shared decision‐making interventions in wound care should include the involvement of stakeholders and programme theory to underpin the interventions developed to consider the complexity of interventions.Implications for the profession and patient carePatients setting out their needs or goals and exploring patient questions are important and should be considered in clinical care.RegistrationThe review protocol was prospectively registered (PROSPERO database: CRD42023389820).No Patient or Public ContributionNot applicable as this is a systematic review.