Raúl Hormazábal-Salgado, Abdi D Osman, Margarita Poblete-Troncoso, Dean Whitehead, Danny Hills
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引用次数: 0
摘要
本综述的目的是识别、评估、整理和分析现有研究，这些研究对帮助理解与痴呆症和/或其他主要神经认知障碍患者和/或其治疗替代决策者使用预先护理指令有关的伦理和决策问题做出了直接贡献。在2021年8月至9月以及2022年7月至11月期间，对Web of Science、Scopus、PubMed、CINAHL、Academic Search Ultimate和MEDLINE数据库进行了搜索，仅限于用英语、西班牙语或葡萄牙语撰写的初级研究。确定了涉及相关主题领域的28项不同质量的研究。这些主题是支持基本需求的自主权（16%），提前做出决定/提前规划并坚持这些决定（52%），以及支持护理人员的决策（32%）。预先护理指令是记录患者护理计划中治疗偏好的重要机制。然而，关于这一主题的现有文献在数量和质量上都是有限的。实践建议包括让决策者参与进来，促进教育干预，探索如何使用和实施这些干预，以及促进社会工作者在医疗团队中的积极参与。
Advanced Care Directives in Residential Aged Care for Residents with Major Neuro-Cognitive Disorders (Dementia): A Scoping Review.
The aim of this review was to identify, assess, collate, and analyze existing research that has made a direct contribution to aiding understanding of the ethical and decision-making issues related to the use of advance care directives for people with dementia and/or other major neurocognitive disorders and/or their surrogate decision-makers on treatment. The Web of Science, Scopus, PubMed, CINAHL, Academic Search Ultimate, and MEDLINE databases were searched between August and September 2021 and July to November 2022 limited to primary studies written in English, Spanish, or Portuguese. Twenty-eight studies of varying quality that addressed related thematic areas were identified. These themes being support for autonomy in basic needs (16%), making decisions ahead/planning ahead and upholding these decisions (52%), and support in decision-making for carers (32%). Advance care directives are an important mechanism for documenting treatment preferences in patient care planning. However, the available literature on the topic is limited in both quantity and quality. Recommendations for practice include involving decision makers, promoting educational interventions, exploring how they are used and implemented, and promoting the active involvement of social workers within the healthcare team.
期刊介绍：
The Journal of Social Work in End-of-Life & Palliative Care, now affiliated with the Social Work in Hospice and Palliative Care Network, explores issues crucial to caring for terminally ill patients and their families. Academics and social work practitioners present current research, articles, and continuing features on the "state of the art" of social work practice, including interdisciplinary interventions, practice innovations, practice evaluations, end-of-life decision-making, grief and bereavement, and ethical and moral issues. The Journal of Social Work in End-of-Life & Palliative Care combines theory and practice to facilitate an understanding of the multi-level issues surrounding care for those in pain and suffering from painful, debilitating, and/or terminal illness.
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