BACKGROUND Clinical practice guidelines for the management of complex chronic conditions in older adults encourage healthcare providers to engage patients in shared decision-making about self-management goals and actions. Yet, healthcare decision-making and communication for this population can pose significant challenges. As a result, healthcare professionals may struggle to help patients define and prioritise their values, goals, and preferences in ways that are clinically and personally meaningful, incorporating physical functioning and quality of life, when faced with numerous diagnostic and treatment alternatives. The aim of this systematic review is to locate and synthesise a body of fine-grained observational research on communication between professionals, older adults, and carers regarding self-management in audio/audio-visually recorded naturalistic interactions. METHODS/DESIGN The paper describes a systematic review of the published conversation analytic and discourse analytic research, using an aggregative thematic approach and following the PRISMA-P guidelines. This review will include studies reporting on adult patients (female or male) aged ≥ 60 years whose consultations are conducted in English in any healthcare setting and stakeholders involved in their care, e.g. general practitioners, nurses, allied health professionals, and family carers. We will search nine electronic databases and the grey literature and two independent reviewers will screen titles and abstracts to identify potential studies. Discrepancies will be resolved via consultation with the review team. The methodological quality of the final set of included studies will be appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research and a detailed description of the characteristics of the included studies using a customised template. DISCUSSION This is the first systematic review to date to locate and synthesise the conversation analytic research on how healthcare professionals raise and pursue talk about self-management with older adults in routine clinical interactions. Amalgamating these findings will enable the identification of effective and potentially trainable communication practices for engaging older adults in healthcare decision-making about the self-management goals and actions that enable the greatest possible health and quality of life in older adulthood. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019139376.

中文翻译：

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让老年人参与医疗保健中的自我管理谈话：系统审查方案。


背景用于管理老年人复杂慢性病的临床实践指南鼓励医疗保健提供者让患者参与有关自我管理目标和行动的共同决策。然而，该人群的医疗保健决策和沟通可能会带来重大挑战。因此，当面对众多的诊断和治疗方案时，医疗保健专业人员可能很难帮助患者以对临床和个人有意义的方式定义和优先考虑他们的价值观、目标和偏好，将身体机能和生活质量结合起来。本系统综述的目的是找到并综合一系列关于专业人士、老年人和护理人员之间关于音频/视听记录的自然交互中的自我管理沟通的细粒度观察研究。方法/设计本文使用聚合主题方法并遵循 PRISMA-P 指南，对已发表的对话分析和话语分析研究进行了系统回顾。本次审查将包括对年龄 ≥ 60 岁的成年患者（女性或男性）的研究报告，这些患者在任何医疗机构中以英语进行咨询，以及参与其护理的利益相关者，例如全科医生、护士、专职医疗专业人员和家庭护理人员。我们将搜索九个电子数据库和灰色文献，两名独立审稿人将筛选标题和摘要以识别潜在的研究。差异将通过与审核小组协商解决。 最终纳入研究的方法学质量将使用乔安娜·布里格斯研究所定性研究批判评估清单进行评估，并使用定制模板对纳入研究的特征进行详细描述。讨论 这是迄今为止第一个系统综述，旨在定位和综合关于医疗保健专业人员如何在常规临床互动中与老年人提出和追求自我管理谈话的对话分析研究。合并这些发现将能够确定有效且可能可训练的沟通实践，使老年人参与有关自我管理目标和行动的医疗保健决策，从而使老年人获得最大程度的健康和生活质量。系统审查注册 PROSPERO CRD42019139376。