Gardiner Clare, Brereton Louise, Frey Rosemary, Wilkinson-Meyers Laura, Gott Merryn
1School of Nursing, The University of Auckland, Auckland, New Zealand.
Palliat Med. 2014 May;28(5):375-90. doi: 10.1177/0269216313510588. Epub 2013 Nov 7.
Research regarding the economic dimensions of palliative care is relatively limited. The economic implications of providing informal care are well recognised; however, within the context of palliative care, little is known about the costs and implications of providing care for a loved one at the end of life.
To explore the financial costs and the financial impact of caring for family members receiving palliative/end-of-life care.
A systematic literature review of empirical research following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Seven electronic databases were searched from inception to April 2012. Inclusion criteria were as follows: articles relating to the financial costs or implications of family caregiving at the end-of-life care, English language articles, empirical research or systematic reviews and articles relating to adults.
The review identified 21 relevant articles; however, evidence relating to the costs and implications of caregiving was relatively limited. The results indicate that the financial costs of caring for someone at the end of life are substantial. Financial costs can result in significant and multidimensional caregiver burden. Various factors were found to mediate the extent of financial burden.
This review identified a significant gap in the evidence base regarding the economic implications of providing care to a family member within a palliative care context. Economic costs and implications are likely to be significant, and research to address this gap is urgently needed, particularly given policy initiatives in a number of developed countries to move the provision of palliative and end-of-life care from hospital to community settings.
关于姑息治疗经济层面的研究相对有限。提供非正式护理的经济影响已得到充分认识;然而,在姑息治疗背景下,对于在生命末期照顾亲人的成本和影响却知之甚少。
探讨照顾接受姑息治疗/临终关怀的家庭成员的经济成本和财务影响。
按照系统评价和Meta分析的首选报告项目(PRISMA)指南对实证研究进行系统文献综述。
检索了7个电子数据库,时间跨度从建库至2012年4月。纳入标准如下:与临终关怀中家庭护理的经济成本或影响相关的文章、英文文章、实证研究或系统评价以及与成年人相关的文章。
该综述确定了21篇相关文章;然而,与护理成本和影响相关的证据相对有限。结果表明,在生命末期照顾某人的经济成本很高。财务成本可能导致照顾者承受重大且多方面的负担。发现各种因素可调节财务负担的程度。
本综述发现,在姑息治疗背景下为家庭成员提供护理的经济影响方面,证据基础存在重大差距。经济成本和影响可能很大,迫切需要开展研究以填补这一差距,特别是考虑到一些发达国家将姑息治疗和临终关怀从医院转向社区环境的政策举措。