The Cunningham Centre for Palliative Care and The University of Notre Dame, Darlinghurst, New South Wales, Australia.
J Pain Symptom Manage. 2011 May;41(5):940-55. doi: 10.1016/j.jpainsymman.2010.07.020. Epub 2011 Mar 12.
Over the past decade, there has been widespread adoption of end-of-life care pathways as a tool to better manage care of the dying in a variety of care settings. The adoption of various end-of-life care pathways has occurred despite lack of robust evidence for their use.
This integrative review identified published studies evaluating the impact of an end-of-life care pathway in the acute and hospice care setting from January 1996 to April 2010.
A search of the electronic databases Scopus and Cumulative Index of Nursing and Allied Health Literature as well as Medline and the World Wide Web were undertaken. This search used Medical Subject Headings key words including "end-of-life care," "dying," "palliative care," "pathways," "acute care," and "evaluation." Articles were reviewed by two authors using a critical appraisal tool.
The search revealed 638 articles. Of these, 26 articles met the inclusion criteria for this integrative review. No randomized controlled trials were reported. The majority of these articles reported baseline and post implementation pathway chart audit data, whereas a smaller number were local, national, or international benchmarking studies. Most of the studies emerged from the United Kingdom, with a smaller number from the United States, The Netherlands, and Australia.
Existing data demonstrate the utility of the end-of-life pathway in improving care of the dying. The absence of randomized controlled trial data, however, precludes definitive recommendations and underscores the importance of ongoing research.
在过去的十年中，临终关怀路径已被广泛采用，作为在各种护理环境中更好地管理临终关怀的工具。尽管缺乏使用这些路径的有力证据，但各种临终关怀路径的采用仍在继续。
本综合评价旨在确定 1996 年 1 月至 2010 年 4 月期间在急性和临终关怀环境中评估临终关怀路径影响的已发表研究。
对 Scopus 和 Cumulative Index of Nursing and Allied Health Literature 电子数据库以及 Medline 和万维网进行了搜索。该搜索使用了包括“临终关怀”、“死亡”、“姑息治疗”、“路径”、“急性护理”和“评估”在内的医学主题词关键词。两位作者使用批判性评价工具对文章进行了审查。
搜索结果显示有 638 篇文章。其中，26 篇文章符合本综合评价的纳入标准。没有报告随机对照试验。这些文章大多报告了实施路径图表审核前后的数据，而少数是地方、国家或国际基准研究。大多数研究来自英国，少数来自美国、荷兰和澳大利亚。
现有数据表明，临终关怀路径在改善临终关怀方面具有实用性。然而，由于缺乏随机对照试验数据，因此无法做出明确的建议，并强调了持续研究的重要性。
