{"title":"预先护理计划对决策冲突和心理困扰的影响:随机对照试验的系统回顾和荟萃分析。","authors":"Young-Ran Yeun","doi":"10.14475/jhpc.2021.24.3.144","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress.</p><p><strong>Methods: </strong>A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models.</p><p><strong>Results: </strong>Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI -0.83 to -0.23), depression (d=-1.22; 95% CI -1.71 to -0.74) and anxiety (d=-0.76; 95% CI -1.12 to -0.39).</p><p><strong>Conclusion: </strong>ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"24 3","pages":"144-153"},"PeriodicalIF":0.0000,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/64/jhpc-24-3-144.PMC10180057.pdf","citationCount":"2","resultStr":"{\"title\":\"The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.\",\"authors\":\"Young-Ran Yeun\",\"doi\":\"10.14475/jhpc.2021.24.3.144\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress.</p><p><strong>Methods: </strong>A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models.</p><p><strong>Results: </strong>Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI -0.83 to -0.23), depression (d=-1.22; 95% CI -1.71 to -0.74) and anxiety (d=-0.76; 95% CI -1.12 to -0.39).</p><p><strong>Conclusion: </strong>ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.</p>\",\"PeriodicalId\":73780,\"journal\":{\"name\":\"Journal of hospice and palliative care\",\"volume\":\"24 3\",\"pages\":\"144-153\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/64/jhpc-24-3-144.PMC10180057.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of hospice and palliative care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14475/jhpc.2021.24.3.144\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of hospice and palliative care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14475/jhpc.2021.24.3.144","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 2
摘要
目的:预先护理计划(Advance care planning, ACP)被广泛认为可以改善临终关怀。本系统回顾和荟萃分析旨在检验ACP干预对决策冲突和心理困扰的影响。方法:于2020年11月检索PubMed、CINAHL、CENTRAL、EMBASE、KISS、KoreaMed和RISS。该研究包括随机对照试验。使用固定效应和随机效应模型汇总数据。结果:确定了14项研究，累计包括1,548名参与者。ACP干预有效缓解决策冲突(d=-0.53;95% CI -0.83 ~ -0.23)，抑郁(d=-1.22;95% CI -1.71至-0.74)和焦虑(d=-0.76;95% CI -1.12 ~ -0.39)。结论:ACP干预对减少决策冲突和心理困扰有显著的积极作用。高偏倚与分配隐藏和盲法有关。本研究的结果有望对临终关怀提供者提高ACP干预措施的有效性有所帮助。
The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Purpose: Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress.
Methods: A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models.
Results: Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI -0.83 to -0.23), depression (d=-1.22; 95% CI -1.71 to -0.74) and anxiety (d=-0.76; 95% CI -1.12 to -0.39).
Conclusion: ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.
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