终末期肾病患者及家属预立医疗照护计划现状及影响因素的混合研究系统评价

Status Quo and Influencing Factors of Advance Care Planning for Patients and their Families with End-Stage Renal Disease:Mixed Methods Systematic Reviews

目的探讨终末期肾病(end-stage renal disease,ESRD)患者及家属对预立医疗照护计划(advance care planning,ACP)的态度、现状及影响因素。方法检索PubMed、Web of Science、中国知网、万方等数据库,筛选ESRD患者及家属对ACP的态度、现状及影响因素相关研究,采用混合研究系统评价方法,对纳入文献进行质量评价和整合分析。结果共纳入18篇文献,归纳3个整合结果:对ACP的认识与态度;实施ACP的现状;实施ACP的影响因素。结论护理人员应运用新媒体加强ACP宣传力度,联合家属早期识别患者需求,建立多学科团队协作模式。通过引导更多ESRD患者及家属参与ACP讨论,有助于建立ACP的正确认识和积极态度。

Objective To explore the status quo and influencing factors of Advance Care Planning(ACP)among End-Stage Renal Disease(ESRD)patients and their families and to know their attitudes towards this planning.Methods Articles in PubMed,Web of Science,CNKI,Wanfang databases were retrieved to determine the studies on the attitudes,status quo and influencing factors of ESRD patients and their families toward ACP.The quality of the included articles was evaluated,and the articles were integrated and analyzed by using the mixed methods systematic reviews.Results A total of 18 studies were included and 3 integrated results were extracted:awareness and attitudes of ACP,status of ACP implementation,and influencing factors of the implementation.Conclusions Healthcare staffs should use new media to strengthen the publicity of ACP,include families in early patient identification and develop multidisciplinary teamwork.By guiding more ESRD patients and their families to participate in ACP discussion,it helps to establish a correct understanding and positive attitudes towards ACP.