Live Hospice Discharge of Individuals With Cognitive Disabilities: A Systematic Review.

IF 4.2 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Victoria M Winogora, Christine E DeForge, Kimberlee Grier, Patricia W Stone
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引用次数: 0

Abstract

Objectives: To systematically review the evidence on live hospice discharge for individuals with cognitive disabilities.

Design: Systematic review.

Setting and participants: Adults with cognitive disabilities enrolled in hospice in the United States.

Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we searched for US-based, English-language, and peer-reviewed literature focused on live discharges from hospice for individuals with cognitive disabilities. We searched PubMed, CINAHL, and Web of Science for articles published between January 1, 2014, through August 1, 2024. We used the Joanna Briggs Institute Analytical Cross-Sectional Studies Appraisal Tool to assess study quality.

Results: After screening 1543 titles and abstracts, we completed a full-text review of 30 articles, of which 8 met inclusion criteria. All included studies were cross-sectional analyses. The indications of cognitive disability varied (ie, dementia diagnosis, positive result on cognitive function assessment), but there were no studies focused on individuals with acquired brain injuries or intellectual and developmental disabilities, nor was the term cognitive disability used in any of the studies. In all studies, the indicator of cognitive disability was associated with live hospice discharge. Other risk factors included female sex (n = 4), minoritized race (n = 4), for-profit hospice ownership (n = 4), and delivery of hospice services at home (n = 2). In all studies, researchers found that individuals with cognitive disabilities had longer hospice lengths of stay.

Conclusions and implications: This systematic review is the first to focus on live discharge from hospice for individuals with cognitive disabilities. All studies focused exclusively on individuals with dementias. Although the term cognitive disability was absent from the literature reviewed, cognitive disability was associated with live discharge. Future research should aim to include the greater cognitive disability community to assess hospice and other end-of-life outcomes to identify potential targets for future intervention.

目的系统性回顾有关认知障碍患者安宁疗护出院的证据:环境和参与者环境和参与者:在美国接受安宁疗护的认知障碍成人:按照系统性综述和荟萃分析首选报告项目(PRISMA)指南,我们检索了以美国为基地、以认知障碍患者安宁疗护出院为主题的英语同行评审文献。我们在 PubMed、CINAHL 和 Web of Science 上检索了 2014 年 1 月 1 日至 2024 年 8 月 1 日期间发表的文章。我们使用乔安娜-布里格斯研究所的分析性横断面研究评估工具来评估研究质量:在筛选了 1543 篇标题和摘要后,我们完成了对 30 篇文章的全文综述,其中 8 篇符合纳入标准。所有纳入的研究均为横断面分析。认知障碍的指征各不相同(即痴呆诊断、认知功能评估结果呈阳性),但没有一项研究是针对后天性脑损伤或智力和发育障碍患者的,也没有一项研究使用认知障碍这一术语。在所有研究中,认知障碍指标都与安宁疗护出院有关。其他风险因素包括女性(4 例)、少数民族(4 例)、营利性安宁疗护所有权(4 例)以及在家提供安宁疗护服务(2 例)。在所有研究中,研究人员都发现,有认知障碍的患者的安宁疗护住院时间更长:本系统性综述首次关注认知障碍患者的安宁疗护出院情况。所有研究都只关注痴呆症患者。尽管所综述的文献中没有认知障碍这一术语,但认知障碍与安宁疗护患者的出院是相关的。未来的研究应旨在纳入更广泛的认知障碍群体,以评估临终关怀和其他临终结局,从而确定未来干预的潜在目标。
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来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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