Hua Lin Ng , Xi Vivien Wu , Siat Yee Yap , Seo Ngee Brian Yeo , Michael Joseph Dino , Ying Jiang
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引用次数: 0
Abstract
Objectives
While Home-based palliative care might be the preferred choice of many, there has been little research exploring the experiences of older adults and caregivers in this setting. This systematic review aims to explore and synthesize the experiences of home-dwelling older adults (aged 60 and above) and their caregivers with Home-based palliative care.
Methods
A Systematic Review and Meta-Synthesis of qualitative and mixed-methods studies was conducted and reported in accordance with PRISMA guidelines. A systematic search across nine electronic databases, as well as grey literature, reference lists and citation lists were conducted. Studies were included with the following criteria: older adult palliative patients and/or their informal caregivers with the primary setting of palliative care delivery at home. Quality appraisal was conducted by two researchers independently using the Critical Appraisal Skills Programme Qualitative Research Checklist and Mixed Methods Appraisal Tool. Data analysis was facilitated by Braun and Clark's thematic analysis, and meta-synthesis was underpinned by Sandelowski and Barroso's guidelines.
Results
A total of 4,931 records were yielded through the electronic database search. After duplicate removal and screening of titles/abstracts and full-texts, a total of 25 studies were included. Five main themes and 11 sub-themes emerged: 1) Living in a diminishing world due to immobility, 2) Bittersweet caregiving process, 3) Navigating a fragmented healthcare system, 4) Maintaining normalcy amongst disruption, 5) Indispensable aspects of Home-based palliative care needed by families.
Conclusions and Implications for Nursing Practice
This meta-synthesis highlights the fundamental significance of embracing a dyadic approach to fully comprehend the intricate dynamics of Home-based palliative care. By recognising the older adult-caregiver dyad as an interconnected unit, future research, therapeutic interventions, and policy initiatives can integrate this dyadic perspective, resulting in more holistic and inclusive Home-based palliative care programs.
Registration
The protocol was registered on PROSPERO (Registration No. CRD42022376864).
期刊介绍：
Seminars in Oncology Nursing is a unique international journal published six times a year. Each issue offers a multi-faceted overview of a single cancer topic from a selection of expert review articles and disseminates oncology nursing research relevant to patient care, nursing education, management, and policy development.
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