The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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引用次数: 2
Abstract
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.
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。
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