终末期病人及家属参与安宁疗护共享决策体验的Meta整合

Experience of end-stage patients and their families participating in shared decision-making for hospice care:a Meta-integration

目的:系统评价终末期病人及家属参与安宁疗护共享决策体验的质性研究,为共享决策在安宁疗护病人中的应用提供循证依据。方法:计算机检索PubMed、Web of Science、the Cochrane Library、中国知网、维普数据库、万方数据库等建库至2023年5月发表的相关质性研究,根据Joanna Briggs Institute(JBI)质性研究质量评价标准对纳入文献进行评价,运用汇集性整合方法进行结果整合。结果:共纳入7篇文献,提炼出28个研究结果,归纳为8个类别,进一步整合为三大主题:终末期病人及家属进行共享决策的前提条件、终末期病人及家属进行共享决策的影响因素、终末期病人及家属进行共享决策的困扰因素。结论:未来应从病人自主性、医患关系、中介角色、预立医疗照护计划及心理支持等多方面促进安宁疗护共享决策的实施。

Objective:To systematically evaluate the qualitative study of end-stage patients and their families participating in shared decision making in hospice care,and to provide evidence-based evidence for the application of shared decision making in hospice patients.Methods:Relevant qualitative studies were retrieved from PubMed,Web of Science,the Cochrane Library,CNKI,VIP,WanFang Database,etc.The retrieval time was from the establishment of each database to May 2023.The included literature was evaluated according to the Joanna Briggs Institute(JBI)qualitative research quality evaluation criteria,and the results were integrated using a pooled integration method.Results:A total of 7 articles were included,and 28 research results were extracted and summarized into 8 categories.It is further integrated into three major themes,including the prerequisite for sharing decision-making between terminal patients and their families,the influencing factors for sharing decision-making between terminal patients and their families,and the troubling factors for sharing decision-making between terminal patients and their families.Conclusion:In the future,we should promote the implementation of shared decision making in hospice care from many aspects,such as patient autonomy,doctor-patient relationship,intermediary role,ACP and psychological support.