Barriers to Advance Care Planning in Older Adults With Dementia, Their Families and Healthcare Professionals: An Umbrella Review of Qualitative Evidence.

IF 1.8 3区社会学 Q2 GERONTOLOGY Research on Aging Pub Date : 2024-05-01 Epub Date: 2024-01-19 DOI:10.1177/01640275241227909

Rie Konno, Kumiyo Inoue, Yumiko Matsushita, Kokoro Hashimoto, Richard Wiechula, Timothy To, Timothy J Schultz

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Abstract

This umbrella review aimed to examine and synthesize qualitative studies that explored the barriers and facilitators of advance care planning for persons with dementia, their families, and their healthcare professionals and caregivers. The modified umbrella review approach developed by the Joanna Briggs Institute was followed. Five major English databases were searched. Four reviews based on 38 primary qualitative studies were included. The methodological quality of the included reviews was moderate to high. The synthesis yielded 16 descriptive themes and five analytical themes: making the wishes/preferences of persons with dementia visible; constructive collaboration based on stakeholders having positive relationships; emotional chaos in facing end-of-life substitute decision-making; initiating the advance care planning process; and preparedness and commitment of healthcare providers to advance care planning. Comprehensive and workable strategies are required to overcome complex and interrelated barriers involving not only healthcare professionals but also organizational and systemic challenges.

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老年痴呆症患者、其家人和医疗保健专业人员预先护理规划的障碍：定性证据综述》。

目的：本综述旨在研究和综合探讨预先护理计划对痴呆症患者、其家人及其医疗保健专业人员和护理人员的障碍和促进作用的定性研究：方法：采用乔安娜-布里格斯研究所（Joanna Briggs Institute）开发的改良总括性综述方法。搜索了五个主要的英文数据库：结果：纳入了基于 38 项主要定性研究的 4 篇综述。所纳入综述的方法学质量为中高水平。综述产生了 16 个描述性主题和 5 个分析性主题：让痴呆症患者的意愿/偏好显而易见；基于利益相关者积极关系的建设性合作；面对临终替代决策时的情绪混乱；启动预先护理规划流程；以及医疗服务提供者对预先护理规划的准备和承诺：要克服复杂且相互关联的障碍，不仅需要医护人员，还需要克服组织和系统方面的挑战，因此需要制定全面可行的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Research on Aging GERONTOLOGY-

CiteScore

4.50

自引率

0.00%

发文量

期刊介绍： Research on Aging is an interdisciplinary journal designed to reflect the expanding role of research in the field of social gerontology. Research on Aging exists to provide for publication of research in the broad range of disciplines concerned with aging. Scholars from the disciplines of sociology, geriatrics, history, psychology, anthropology, public health, economics, political science, criminal justice, and social work are encouraged to contribute articles to the journal. Emphasis will be on materials of broad scope and cross-disciplinary interest. Assessment of the current state of knowledge is as important as provision of an outlet for new knowledge, so critical and review articles are welcomed. Systematic attention to particular topics will also be featured.