决策辅助工具在关节置换术患者中应用的范围综述

A Scoping Review on the Application of Decision Aid Tools in Patients Undergoing Joint Arthroplasty

摘要: 目的：对关节置换术患者治疗中的决策辅助工具(Patient Decision Aid, PDA)进行范围综述，明确应用现状、内容要素及应用效果，为针对性构建国内关节置换术患者决策辅助工具提供参考。方法：检索PubMed、Cochrane Library、Web of Science、中国生物医学文献数据库、万方数据库、维普数据库、中国知网等中英文数据库，检索时限为建库至2025年3月，对纳入文献进行汇总与分析。结果：共纳入13篇文献，研究主要涉及工具的可行性和可用性、患者的决策相关结局、患者的知识水平变化3个方面。内容要素主要包括健康信息、决策指导、参考证据及补充信息。信息的呈现形式主要包括：使用图表呈现抽象的疾病相关知识；以评分表帮助患者整理自己的决策偏好；通过网页实现交互式功能。结论：决策辅助工具可显著降低患者的决策冲突水平，提高决策质量，并具有良好的可行性。期待未来开展更多高质量的随机对照研究，完善评价指标，并探索决策辅助工具最佳干预时机，加强决策过程中的专业支持，结合我国国情和人群特征，加速关节置换术患者相关决策辅助工具的开发，为关节置换术患者提供高质量的决策支持。

Abstract: Objective: To conduct a scoping review of decision aids used in the management of patients undergoing arthroplasty, clarifying their current application status, key components, and outcomes, so as to inform the development of tailored decision aids for arthroplasty patients in China. Methods: We searched both Chinese and English databases, including PubMed, Cochrane Library, Web of Science, CBM, Wanfang, VIP, and CNKI, from their inception to March 2025. The included literature was summarized and analyzed. Results: A total of 13 articles were included, focusing mainly on feasibility and usability of the tools, decision-related patient outcomes, and changes in patient knowledge levels. The core components of the tools included health information, decision guidance, reference evidence, and supplementary materials. Information was primarily presented through visual charts to explain abstract disease-related knowledge, scoring forms to help patients clarify their decision preferences, and interactive web-based platforms. Conclusions: Decision aids can significantly reduce patients’ decision conflict and improve decision quality, demonstrating good feasibility. Future high-quality randomized controlled trials are needed to refine outcome measures, explore optimal timing for intervention, and strengthen professional support during the decision-making process. Adapting these tools to China’s national context and population characteristics will accelerate the development of decision aids for arthroplasty patients and provide high-quality decision support.