整形外科疾患のリハビリテーションにおける共有意思決定モデルに基づいた目標設定に関するスコーピングレビュー

A scoping review of goal setting research based on the shared decision-making model for people with orthopedic disorders in rehabilitation

スコーピングレビューの手法に則って整形外科領域のリハビリテーションにおける目標設定に関連する文献を探索し，リサーチギャップの分析を行った．PubMed，Web of Science，Scopus，ProQuest，CINAHLを用いて検索を実行し，最終的に17編を適格論文として精読した．対象疾患は脊髄損傷が10編と最多であり，多様な整形外科疾患を網羅していなかった．介入研究においては，意思決定支援ツールが未使用の研究や，目標設定やその後の介入において合意形成のプロセスが不十分な研究も散見され，整形外科領域のリハビリテーションにおける目標設定に関するさらなる検証の必要性が示唆された．

　This scoping review aims to identify research gaps in goal-setting processes during rehabilitation programs for people with orthopedic disorders. Study design: This scoping review followed Arksey and O'Malley's framework. Data sources: Electronic searches of PubMed, Web of Science, Scopus, ProQuest, and CINAHL were conducted using predetermined search strategies. Eligibility criteria: We included studies involving goal-setting processes in rehabilitation for patients with orthopedic disorders without limiting the region/country or target disease. Data extraction and synthesis: Two reviewers independently screened the abstracts and full texts and extracted the data based on the eligibility criteria. A third reviewer adjudicated any disagreement and collated the extracted data. Results: Results of the database searches yielded 968 studies, 17 of which were deemed eligible to include in this review. Most studies enrolled patients with spinal cord injuries (n=10, 58.8%), while the number of other diseases was 2 or less. There were only a few studies using decision aids to identify occupational problems. Conclusion: Our review indicates that there is a scarcity of evidence of goal setting in orthopedic rehabilitation. Furthermore, establishing clinical practice is required, while focusing on goal-setting processes.