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100 Shared decision-making in minority ethnic groups: an umbrella review
  1. Emma Harris,
  2. Salime Goharinezhad,
  3. Felicity Astin
  1. School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK

Abstract

Introduction Shared decision-making (SDM) is central to patient-centred care. However, patients from minority ethnic groups in Western countries report lower levels of involvement in SDM for health tests/treatments. The aim of this umbrella review was to synthesize findings from published literature reviews that report on SDM with people from minority ethnic groups.

Methods This review followed Joanna Briggs Institute’s methods for conducting umbrella reviews. Five databases (CINAHL, Cochrane Library, PsycINFO, PubMed, Web of Science) were systematically searched from inception to November 2023. Inclusion criteria were systematic reviews reporting on SDM barriers and/or facilitators with patients from minority ethnic groups in Western healthcare settings. Findings were synthesized using content analysis.

Results Of the 6194 articles retrieved, 20 reviews were eligible for inclusion. Most studies in the reviews were conducted in the USA with Black/African American people. Seventy-five percent of reviews reported on SDM in oncology settings. Patient factors influencing SDM included involvement of family and religious community members; cultural values and beliefs; patient education levels; and preference for consultations with health professionals from the same gender and ethnicity. Health professional and organizational factors influencing SDM included language barriers, lack of easily accessible high-quality interpreters, differences in non-verbal communication, and inadequate cultural competency.

Discussion Diversity and inclusion in healthcare organisations and practices are needed to address health disparities. Initiatives to address unmet decision support needs faced by patients and families from minority ethnic groups could include, recruiting a diverse health professional workforce, the provision of mandatory training on culturally sensitive SDM, involvement of service users in the development of SDM tools and improvement of interpreter services.

Conclusion(s) More research is needed to explore how preference sensitive SDM happens, in non-oncology settings, between health professionals and people from minority ethnic groups in Europe.

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