Voluntarily stopping eating and drinking (VSED): A systematic mixed-methods review focusing on the carers’ experiences

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES Health Policy Pub Date : 2024-09-30 DOI:10.1016/j.healthpol.2024.105174

Christina Mensger , Yang Jiao , Maximiliane Jansky , Christian Banse , Friedemann Nauck , Monika Nothacker , Henrikje Stanze

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Abstract

Background

Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED.

Methods

In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021. We included quantitative and qualitative research examining the experiences, attitudes, and knowledge of people confronted with VSED. We inductively analyzed the data after quantitative data transformation. We assessed quality and confidence using the Mixed-Methods Appraisal Tool and GRADE-CERQual approach, respectively. This study was registered in PROSPERO (CRD42022283743).

Findings

We identified 22 eligible articles, comprising 16 studies. The participants were healthcare professionals and relatives, but not individuals undertaking VSED. We present here our findings on the challenges of accompanying VSED, positive experiences with VSED, and the identified needs. Support during VSED is needed at multiple levels (medical care, family relief, course planning), and the willingness to accompany VSED is very high among healthcare professionals. However, there are several problems, the most obvious being the lack of knowledge and expertise regarding VSED, placing a great burden on families and professionals. The confidence in the review findings ranged from moderate to low.

Interpretation

Evidence-based guidance, in-depth knowledge, and training of healthcare professionals can greatly reduce the burden and fear among individuals accompanying VSED.

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自愿停止饮食（VSED）：以照顾者的经历为重点的系统性混合方法综述。

背景：自愿停止进食和饮水（VSED）是提前结束生命的一种方式。我们综合了有关 VSED 的经验数据：在这项系统性混合方法综述中，我们检索了 MEDLINE、CINAHL、PsycINFO、Google Scholar 和 BELIT 在 2013 年 1 月 1 日至 2021 年 11 月 12 日期间发表的英文和德文文章。我们收录了对面临 VSED 的人们的经历、态度和知识进行研究的定量和定性研究。我们对定量数据转换后的数据进行了归纳分析。我们分别使用混合方法评估工具和 GRADE-CERQual 方法对研究质量和可信度进行了评估。本研究已在 PROSPERO（CRD42022283743）上注册：我们确定了 22 篇符合条件的文章，包括 16 项研究。参与者包括医疗保健专业人员和亲属，但不包括进行 VSED 的个人。我们在此介绍我们在 VSED 陪同过程中遇到的挑战、VSED 的积极经验以及已确定的需求方面的研究结果。VSED 期间需要多层次的支持（医疗护理、家庭救济、课程规划），医护专业人员陪同 VSED 的意愿非常高。然而，也存在一些问题，最明显的是缺乏有关 VSED 的知识和专业技能，这给家庭和专业人员带来了沉重的负担。综述结果的可信度从中度到低度不等：以证据为基础的指导、深入的知识以及对医护专业人员的培训可以大大减轻 VSED 患者的负担和恐惧。

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

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.