双层预期护理规划:对患者护理人员干预和影响的系统审查
Xiaohang Liu1, Tongyao Wang1, Denise Shuk Ting Cheung1
1School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong.
BMJ supportive & palliative care
|October 19, 2023
概括
家庭护理人员参与预先护理计划 (ACP) 改善了终身护理. 本综述总结了干预措施,发现了在ACP完成的好处,并为患者-护理人员双向规划提供了一个模型.
科学领域:
- 老年学是一门学科.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 家庭护理人员的参与对于高质量的终身护理和减少代孕妇决策负担至关重要.
- 现有的系统性审查尚未全面解决涉及患者及其家属的预先护理规划 (ACP) 干预措施.
研究的目的:
- 系统地审查和总结目前的预先护理计划 (ACP) 干预措施,这些干预措施积极涉及患者及其家庭护理人员.
主要方法:
- 在2022年9月之前,对五个英语和两个中文数据库进行了系统搜索.
- 符合条件的研究包括使用原始数据的实验设计,使用Joanna Briggs Institute工具进行批判性评估.
- 用叙事合成分析了数据.
主要成果:
- 包括28篇文章 (15个RCT,13个准实验) 在内.
- 干预的关键组成部分包括促进ACP,促进讨论和确保后续行动的战略,强调家庭照顾者的作用.
- 干预措施在ACP完成方面显示出好处,但对过程结果和EOL护理质量的发现是不一致的. 一个逻辑模型被开发为二元的ACP.
结论:
- 患者-护理人员双向ACP干预措施有望改善EOL沟通和决策.
- 提出了一个逻辑模型,以指导未来实施双向ACP.
- 需要进一步的经验研究来完善和在文化上适应这个模型的现实世界设置.
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