护理学报 ›› 2024, Vol. 31 ›› Issue (2): 53-58.doi: 10.16460/j.issn1008-9969.2024.02.053
李嘉琪1, 叶向红1, 左俊焘1, 徐瑶2, 姚红林1
LI Jia-qi1, YE Xiang-hong1, ZUO Jun-tao1, XU Yao2, YAO Hong-lin1
摘要: 目的 系统评价终末期患者营养支持决策过程中患者、家属和医护人员的感受,为改善患者及家属决策体验提供新思路。方法 计算机检索Cochrane图书馆、PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库中有关终末期患者营养支持决策过程、体验的质性研究或混合研究。检索时限为建库至2023年8月。基于JBI循证卫生保健中心推荐的PICoS模型确定文献,采用MAXDQA2022软件对纳入文献进行归类整合。结果 共纳入10篇文献,提炼38个主题,归纳9个类别,最终形成4个整合结果:决策者的多维度思考得出结果;决策者迫切需要专业支持;决策者认知影响决策结果;决策者同样需要心理干预。结论 终末期患者营养支持决策需要经过多方协商、沟通,关注决策者心理体验,必要时给予专业支持,改善患者及家属体验。
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[1] Ferrell BR, Temel JS, Temin S, et al.Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update[J]. J Clin Oncol, 2017, 35(1):96-112.DOI:10.1200/JCO.2016.70.1474. [2] Orrevall Y, Tishelman C, Permert J, et al.Nutritional support and risk status among cancer patients in palliative home care services[J]. Support Care Cancer, 2009, 17(2):153-161. DOI: 10.1007/s00520-008-0467-4. [3] Good P, Richard R, Syrmis W, et al. Medically assisted hydration for adult palliative care patients[J]. Cochrane Database Syst Rev, 2014, 2014(4): Cd006273.DOI:10.1002/14651858. [4] Druml C, Ballmer PE, Druml W, et al.ESPEN guideline on ethical aspects of artificial nutrition and hydration[J]. Clin Nutr, 2016, 35(3):545-556.DOI:10.1016/j.clnu.2016.02.006. [5] Stern C, Jordan Z, Mcarthur A.Developing the review question and inclusion criteria[J]. Am J Nurs, 2014, 114(4):53-56. DOI: 10.1097/01.NAJ.0000445689.67800.86. [6] 靳英辉, 高维杰, 李艳, 等. 质性研究证据评价及其循证转化的研究进展[J]. 中国循证医学杂志, 2015,15(12):1458-1464. DOI: 10.7507/1672-2531.20150237. [7] Colvin CJ, Garside R,Wainwright M,et al.Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence[J]. Implement Sci, 2018, 13(Suppl 1): 13. DOI: 10.1186/s13012-017-0691-8. [8] Kingdon A, Spathis A, Autunes B, et al.Medical communication and decision-making about assisted hydration in the last days of life: a qualitative study of doctors experienced with end of life care[J]. Palliat Med, 2022, 36(7):1080-1091. DOI: 10.1177/02692163221097309. [9] Van der riep P, Good P, Higgins I, et al. Palliative care professionals' perceptions of nutrition and hydration at the end of life[J]. Int J Palliat Nurs, 2008, 14(3):145-151. DOI:10.12968/ijpn.2008.14.3.28895. [10] Cohen MZ, Torres-vigil I, Burbach BE, et al. The meaning of parenteral hydration to family caregivers and patients with advanced cancer receiving hospice care[J]. J Pain Symptom Manage, 2012, 43(5):855-865. DOI:10.1016/j.jpainsymman.2011.06.016. [11] Rapoport A, Shaheed J, Newman C, et al.Parental perceptions of forgoing artificial nutrition and hydration during end-of-life care[J]. Pediatrics, 2013,131(5):861-869. DOI: 10.1542/peds.2012-1916. [12] Fournier V, Belghiti E, Brunet L, et al.Withdrawal of artificial nutrition and hydration in neonatal intensive care: parents' and healthcare practitioners' views[J].Med Health Care Philos, 2017, 20(3):365-371. DOI:10.1007/s11019-017-9754-5. [13] Kitzinger J, Kitzinger C.Deaths after feeding-tube withdrawal from patients in vegetative and minimally conscious states: a qualitative study of family experience[J]. Palliat Med,2018,32(7):1180-1188.DOI:10.1177/0269216318766430. [14] Firnhaber GC, Roberson DW, Kolasa KM.Nursing staff participation in end-of-life nutrition and hydration decision-making in a nursing home: a qualitative study[J]. J Adv Nurs, 2020,76(11):3059-3068.DOI:10.1111/jan.14491. [15] Barrado-Martín Y, Nair P, Anantapong K, et al.Family caregivers' and professionals' experiences of supporting people living with dementia's nutrition and hydration needs towards the end of life[J]. Health Soc Care Community, 2022, 30(1):307-318. DOI:10.1111/hsc.13404. [16] Hochwald IH, Yakov G, Radomyslsky Z, et al.Ethical challenges in end-stage dementia: perspectives of professionals and family care-givers[J]. Nurs Ethics, 2021, 28(7-8): 1228-1243. DOI:10.1177/0969733021999748. [17] Fairrow AM, Mccallum TJ, Messinger-rapport BJ. Preferences of older African-Americans for long-term tube feeding at the end of life[J]. Aging Ment Health, 2004, 8(6): 530-534. DOI:10.1080/13607860412331303829. [18] Loofs TS, Haubrick K.End-of-life nutrition considerations: attitudes, beliefs, and outcomes[J].Am J Hosp Palliat Care, 2021, 38(8):1028-1041.DOI:10.1177/1049909120960124. [19] Amano K, Morita T, Miyamoto J, et al.Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings[J]. Support Care Cancer, 2018,26(8):2793-2799.DOI:10.1007/s00520-018-4104-6. [20] Regan A, Colling J.Caring for people who are dying: priorities at the end of life[J]. Nurs Stand, 2015,29(24):51-58. DOI: 10.7748/ns.29.24.51.e9710. [21] Brinkman-Stoppelenburg A, Rietjens JA, Van Der Heide A. The effects of advance care planning on end-of-life care: a systematic review[J]. Palliat Med, 2014, 28(8): 1000-1025. DOI: 10.1177/0269216314526272. [22] Peacock SC.The experience of providing end-of-life care to a relative with advanced dementia:an integrative literature review[J]. Palliat Support Care, 2013, 11(2):155-168. DOI: 10.1017/S1478951512000831. [23] 宋静雨,舒瑶雅,王蒙蒙,等.终末期病人配偶照护者需求的Meta整合[J].护理学报, 2021, 28(20):30-38. DOI:10.16460/j.issn1008-9969.2021.20.030. [24] 李姗姗,黄红艳,李媛媛,等.终末期慢性肾脏病患者治疗决策需求的研究进展[J].护理学报,2023,30(7):38-43. DOI:10.16460/j.issn1008-9969.2023.07.038. |
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