对弱势和处于不利地位的成年人进行预先护理计划:系统审查和叙事综合
Samantha Jane Brean1,2, Katrina Recoche2, Leeroy William3,4
1Advance Care Planning, Eastern Health, Wantirna, Victoria, Australia sam.brean@easternhealth.org.au.
BMJ supportive & palliative care
|June 28, 2023
概括
对弱势成年人的预先护理计划 (ACP) 干预措施需要改进. 促进者技能和个性化沟通是增强ACP经验和不同人群的成果的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 与一般人群相比,在弱势和处于不利地位的人群中,在预先护理计划 (ACP) 完成率方面存在着记录的差距.
- 这种差异凸显了需要有针对性的战略,以改善对这些群体的参与.
- 了解现有的阿克苏干预措施的有效性对于为未来的做法提供信息至关重要.
研究的目的:
- 确定用于预先护理规划 (ACP) 对弱势和处境不利的成年人进行干预的工具,准则或框架.
- 探索这些人群的经验和经验结果与ACP干预措施.
- 为制定和实施有效的非洲国家和地区计划提供信息.
主要方法:
- 从2010年1月到2022年3月,在六个数据库中进行了系统的文献搜索.
- 包括专注于原创的,经过同行评审的研究,详细介绍了使用工具,指导方针或具有定性发现的框架的ACP干预措施的研究.
- 采用叙事综合方法来分析确定的研究.
主要成果:
- 18项研究符合纳入标准,其中8项涉及亲属,护理人员或替代决策者.
- 干预措施在各种环境中进行,包括门诊,社区环境,养老院和监狱.
- 除了干预本身,促进者的技能和方法被认为是关键的,从参与者的经验中出现的不确定性,信任,文化和决策行为的主题.
结论:
- 提前护理规划 (ACP) 沟通需要通过整体和个性化的方法来加强.
- 促进者必须具备足够的技能,并配备适当的工具和信息,以支持非洲和非洲国家和地区的决策.
- 优化ACP有效性需要解决沟通障碍,并在弱势群体中建立信任.
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