A Systematic Review of Shared Decision-Making in Cleft Care.

ObjectiveTo explore the use of shared decision-making (SDM), a collaborative approach to care between healthcare providers, patients, and their families, in cleft lip and/or palate (CL/P) care.DesignPubMed, CINHAL, Embase, and Dentistry & Oral Sciences Database were searched for studies reporting on SDM in CL/P pediatric care (<19 years). There were no restrictions on date, language, or study design other than case studies and systematic reviews.ResultsA total of 13 studies were included. Overall, parents reported high levels of perceived involvement in SDM. Pediatric patients shared this view, though the desire for SDM was age-dependent with patients expressing a greater desire for involvement as they aged. Qualitative data revealed 4 main themes, including understanding and knowledge of cleft care and treatment, factors influencing decision-making and patient autonomy, psychosocial and emotional dimensions in decision-making, and moral responsibility and identity in decision-making.ConclusionThe current study highlights that SDM is valued by parents and patients in CL/P care. Further research is needed to understand how SDM can be more clearly integrated into routine CL/P care. Specifically, studies should explore the gap between perceived and actual involvement using standardized SDM measures, as well as identify key barriers and enablers to effective implementation.