专业成人姑息治疗中的家庭丧亲支持干预:快速混合方法系统回顾

IF 3.4 3区 医学 Q1 NURSING
Torsten Schwalbach, Marco Riguzzi, Myrta Kohler, Rahel Naef
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引用次数: 0

摘要

目的:综合有关失亲前后家庭支持干预对丧亲结果的影响的证据,以及家庭对其在专科姑息治疗中的有用性和益处的看法。根据JBI和Cochrane指南设计一个快速混合方法系统评价。使用混合方法评价工具评价研究质量。定性和定量数据分析采用元聚合和叙事分析方法结合叙事综合。数据来源我们检索了Medline, CINAHL, PsycINFO, Embase和Cochrane图书馆,并纳入了2004年至2024年间发表的评估专家成人姑息治疗中失丧前后家庭支持和评估丧亲结果的文章。结果检索得到3682条记录。我们纳入了39项研究,其中大部分为中等至高质量研究(57%为定量研究)。研究结果表明,丧前支持,如以家庭为中心的干预和临终时的沟通,可以减轻丧后焦虑、抑郁和悲伤。个人和团体的失丧后支持干预可以减少焦虑、痛苦和悲伤,同时改善幸福感。家庭需要个性化和全面的丧前丧后支持,很少有人不需要或接受它。与丧亲、支持和障碍相关的耻辱感会阻碍获得。结论:纳入的研究表明,失联前后的家庭支持干预措施效果不一,表明当可获得且适合家庭需要时,这些干预措施是有益的。需要高质量的干预研究来评估更广泛的家庭丧亲结局。影响姑息治疗护士和其他卫生专业人员应根据家庭需要量身定制护理,在患者死亡前开始提供家庭支持,并确保公平获得丧亲服务。我们的研究结果可以指导姑息治疗专业人员设计有效、个性化和可获得的服务,并指导决策者分配丧亲护理资源。调查结果突出了研究需求,包括调查护理障碍和服务可及性。需要高质量的研究来了解谁从促进健康的丧亲支持中受益最大,以及为什么受益。报告方法我们遵守PRISMA指南。患者和公众贡献:没有患者和公众贡献。协议注册开放科学框架https://osf.io/36jeu
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Family Bereavement Support Interventions in Specialist Adult Palliative Care: A Rapid Mixed‐Methods Systematic Review
AimTo synthesise evidence on the impact of pre‐ and post‐loss family support interventions on bereavement outcomes and families' perceptions of their usefulness and benefits in specialist palliative care.DesignA rapid mixed‐methods systematic review drawing on JBI and Cochrane guidance. Study quality was appraised using the Mixed‐Methods Appraisal Tool. Qualitative and quantitative data were analysed using a meta‐aggregation and narrative analysis approach combined with narrative synthesis.Data SourceWe searched Medline, CINAHL, PsycINFO, Embase and Cochrane Library and included articles published between 2004 and 2024 that evaluated pre‐ and post‐loss family support in specialist adult palliative care and assessed bereavement outcomes.ResultsThe search yielded 3682 records. We included thirty‐nine mostly moderate to high‐quality studies (57% quantitative). Results suggest that pre‐loss support, like family‐focused interventions and communication during dying, may mitigate post‐loss anxiety, depression and grief. Individual and group post‐loss support interventions may reduce anxiety, distress and grief while improving well‐being. Families desire individualised and comprehensive pre‐ and post‐loss support, with few not needing or accepting it. Stigma associated with bereavement, support and barriers can hinder access.ConclusionIncluded studies demonstrated mixed effects of pre‐ and post‐loss family support interventions, suggesting they are beneficial when accessible and tailored to family needs. High‐quality intervention research assessing a broader range of family bereavement outcomes is needed.ImpactPalliative care nurses and other health professionals should tailor their care to family needs, start family support before patient death and ensure equitable access to bereavement services. Our results may guide palliative care professionals in designing effective, personalised and accessible services and policymakers in allocating resources for bereavement care. Findings highlight research needs, including investigating barriers to care and accessibility of services. High‐quality research is needed to understand who benefits the most from health‐promoting bereavement support and why.Reporting MethodWe adhered to the PRISMA guideline.Patient and Public ContributionNo Patient and Public Contribution.Protocol RegistrationOpen Science Framework https://osf.io/36jeu
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来源期刊
CiteScore
6.40
自引率
7.90%
发文量
369
审稿时长
3 months
期刊介绍: The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.
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