探索居家姑息关怀环境中老年人及其照护者的经历:系统回顾与元综合》。

IF 2.3 4区 医学 Q1 NURSING Seminars in Oncology Nursing Pub Date : 2024-12-01 DOI:10.1016/j.soncn.2024.151753
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

摘要

目的:虽然居家姑息关怀可能是许多人的首选,但很少有研究探讨老年人和照护者在这种环境下的经历。本系统综述旨在探索和总结居家老年人(60 岁及以上)及其照护者在居家姑息关怀方面的经验:方法:根据 PRISMA 指南,对定性研究和混合方法研究进行了系统综述和元综合。在九个电子数据库以及灰色文献、参考文献目录和引用文献目录中进行了系统性检索。纳入研究的标准如下:老年姑息关怀患者和/或其非正式照护者,姑息关怀服务的主要场所在家中。由两名研究人员使用 "批判性评估技能计划定性研究核对表 "和 "混合方法评估工具 "独立进行质量评估。数据分析采用了布劳恩和克拉克的主题分析法,元综合则以桑德罗斯基和巴罗佐的指南为基础:通过电子数据库搜索共获得 4931 条记录。在删除重复内容、筛选标题/摘要和全文后,共纳入 25 项研究。得出了 5 个主题和 11 个次主题:1)因行动不便而生活在一个日渐衰弱的世界中;2)苦乐参半的护理过程;3)驾驭支离破碎的医疗保健系统;4)在混乱中保持正常状态;5)家庭所需的居家姑息关怀不可或缺的方面:本综述强调了采用二元方法来充分理解居家姑息关怀的复杂动态的根本意义。通过认识到老年人-护理者二元组合是一个相互关联的单元,未来的研究、治疗干预和政策措施可以整合这种二元组合视角,从而制定出更全面、更具包容性的居家姑息关怀计划:该方案已在 PROSPERO 上注册(注册号:CRD42022376864)。
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Exploring the Experiences of Older Adults and Their Caregivers in Home-Based Palliative Care Setting: A Systematic Review and Meta-Synthesis

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).
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来源期刊
Seminars in Oncology Nursing
Seminars in Oncology Nursing Nursing-Oncology (nursing)
CiteScore
3.40
自引率
0.00%
发文量
68
审稿时长
45 days
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.
期刊最新文献
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