Understanding Transition From Home to Inpatient Setting in Palliative Care: A Qualitative Synthesis

IF 4 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2026-12-01 Epub Date: 2026-08-19 DOI:10.1016/j.jpainsymman.2026.08.004

Yijing Li MSN, Shanshan Liu MSN, Ting Yu MSN, Yan Jiang PhD

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引用次数: 0

Abstract

Context

Patients receiving palliative care often experience multiple transitions among care settings at the end of life, with transitions from home to inpatient settings being the most common. However, how these transitions occur and how care needs and preferences change over time have not been systematically synthesized.

Objective

To synthesize the experiences of patients receiving palliative care and their caregivers regarding transitions from home to inpatient settings.

Methods

A qualitative evidence synthesis was conducted following JBI guidance and reported in accordance with ENTREQ. The PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases were searched from inception to January 2024 and updated in March 2026. The eligible studies were assessed using the Joanna Briggs Institute critical appraisal instrument for qualitative research. Thematic synthesis was conducted by using Thomas and Harden’s approach.

Findings

A total of nine studies were included. Three themes emerged: 1) triggers for making decisions, including symptom crises, caregiving burden, treatment preferences, and reluctance to die at home; 2) concerns about inpatient care, involving continuity of care, communication, and comfort; 3) reflections on the care transfer, with caregivers viewing the transition as the right decision and describing a calmer period with their loved ones.

Conclusions

Preferences regarding the place of care at the end of life are not a clear and stable choice but are shaped by uncertainty relating to the illness, the caregiver and the services needed.

查看原文本刊更多论文

理解姑息治疗从家庭到住院环境的转变：定性综合。

背景：接受姑息治疗的患者在生命结束时通常会在护理环境中经历多次过渡，从家庭到住院环境的过渡是最常见的。然而，这些转变是如何发生的，以及护理需求和偏好是如何随时间变化的，还没有系统地综合出来。目的：综合接受姑息治疗的患者及其护理人员从家庭过渡到住院环境的经验。方法：在JBI指导下进行定性证据综合，并按照ENTREQ报告。检索了PubMed、Web of Science、Cochrane Library、Embase、CINAHL、CNKI、万方和VIP数据库，检索时间为建库至2024年1月，更新时间为2026年3月。合格的研究使用乔安娜布里格斯研究所的定性研究关键评估工具进行评估。运用Thomas和Harden的方法进行主题合成。结果：共纳入9项研究。出现了三个主题：1)决策触发因素，包括症状危机、护理负担、治疗偏好和不愿在家中死亡；2)对住院病人护理的关注，包括护理的连续性、沟通和舒适；3)对护理转移的反思，护理人员将转移视为正确的决定，并描述与他们所爱的人的平静时期。结论：对临终护理地点的偏好并不是一个明确和稳定的选择，而是由与疾病、护理者和所需服务相关的不确定性所塑造的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.