养老机构医护人员安宁疗护实践体验的Meta整合

The experience of medical staff upon the hospice care practice in nursing homes:a Meta-synthesis of qualitative research

目的系统评价养老机构医护人员安宁疗护实践体验的质性研究,为养老机构开展安宁疗护服务提供参考依据。方法检索Web of Science、PubMed、Cochrane Library、Embase、CINAHL、中国知网、中国生物医学文献数据库、万方、维普数据库中关于养老机构医护人员安宁疗护实践体验的相关质性研究,检索时限为建库至2024年3月21日,运用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准进行文献质量评价,运用汇集性整合方法进行结果整合。结果共纳入15篇文献,提炼出47个研究结果,归纳为11个类别,形成4个整合结果:医护人员的安宁疗护工作职责;医护人员在实践中的情绪体验;应对负性体验,收获个人成长;养老机构实施安宁疗护面临的现实困境。结论养老机构在开展安宁疗护服务过程中面临着多重阻碍与挑战。未来应着力于完善养老机构安宁疗护政策,构筑安宁疗护服务支持体系,推动死亡素养的养成与实践,以促进养老机构安宁疗护服务健康长远发展。

ObjectiveTo systematically evaluate the qualitative research on the practical experience of hospice care among medical staff in nursing homes,and to provide a reference basis for the implementation of hospice care services in nursing homes.MethodsThe qualitative research on the practical experience of hospice care among medical staff in nursing homes was searched from databases including the Web of Science,PubMed,Cochrane Library,Embase,CINAHL,China National Knowledge Infrastructure,China Biology Medicine disc,Wanfang Data and VIP Database.The retrieval period was from the establishment of the database to March 21,2024.The quality evaluation standards for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center were used to evaluate the quality of the literature.The results were integrated by the method of aggregative integration.ResultsA total of 15 studies were included,and 47 clear research results were extracted,summarized into 11 categories,and 4 integrated results were obtained:the palliative care work responsibilities of medical staff;the emotional experience of medical staff in practice;coping with negative experience and gaining personal growth;the practical dilemmas faced by nursing homes when implementing hospice care.ConclusionsNursing homes face multiple obstacles and challenges in the process of providing hospice care services.It is recommended that future research should focus on improving the policy system of hospice care in nursing homes,building a support system for hospice care services,and promoting the development and practice of death literacy among the public,so as to promote the healthy and long-term development of hospice care services in nursing homes.