Wang Chong-Wen, Chan Cecilia L W
Centre on Behavioral Health,The University of Hong Kong,Hong Kong.
Palliat Support Care. 2015 Dec;13(6):1711-20. doi: 10.1017/S1478951515000802. Epub 2015 Jun 15.
This systematic review aimed to examine end-of-life (EoL) care research undertaken in an Eastern cultural context--Hong Kong--with the hope of better informing EoL care professionals and policy makers and providing lessons for other countries or areas that share similar EoL care challenges.
Eight databases were searched from their respective inception through to August of 2014. All of the resulting studies conducted in Hong Kong and relevant to EoL care or palliative care were examined. The included studies were assessed with respect to study design, care settings, participants, research themes, and major findings.
Some 107 publications published between 1991 and 2014 were identified. These studies were undertaken at a range of places by different professionals. Of the total, 44 were led by physicians, 36 by nurses, 17 by social workers, and 10 by other professionals. Participants included both inpatients and outpatients with different illnesses, nursing home residents, older community-dwelling adults, deceased individuals, care staff, and informal caregivers. A total of 13 research themes were identified: (1) attitudes to or perceptions of death and dying; (2) utilization of healthcare services, (3) physical symptoms or medical problems; (4) death anxiety or mental health issues; (5) quality of life; (6) advance directives or advance care planning; (7) supportive care needs, (8) decision making; (9) spirituality; (10) cost-effectiveness or utility studies; (11) care professionals' education and training; (12) informal caregivers' perceptions and experience; and (13) scale development or validation.
While there has been a wide and diverse range of research activities in Hong Kong, EoL care services at primary care settings should be strengthened. Some priority areas for further research are recommended.
本系统评价旨在审视在东方文化背景下——中国香港——开展的临终关怀研究，以期为临终关怀专业人员和政策制定者提供更充分的信息，并为面临类似临终关怀挑战的其他国家或地区提供经验教训。
检索了八个数据库，检索时间跨度从各数据库建库至2014年8月。对所有在香港开展且与临终关怀或姑息治疗相关的研究进行审查。纳入的研究根据研究设计、护理场所、参与者、研究主题和主要发现进行评估。
共识别出1991年至2014年间发表的约107篇文献。这些研究由不同专业人员在一系列场所开展。其中，44项研究由医生主导，36项由护士主导，17项由社会工作者主导，10项由其他专业人员主导。参与者包括患有不同疾病的住院患者和门诊患者、养老院居民、社区老年居民、逝者、护理人员和非正式照护者。共确定了13个研究主题：（1）对死亡和临终的态度或认知；（2）医疗服务的利用情况；（3）身体症状或医疗问题；（4）死亡焦虑或心理健康问题；（5）生活质量；（6）预先指示或预先护理计划；（7）支持性护理需求；（8）决策制定；（9）精神层面；（10）成本效益或效用研究；（11）护理专业人员的教育与培训；（12）非正式照护者的认知和经历；（13）量表的开发或验证。
尽管香港开展了广泛多样的研究活动，但基层医疗场所的临终关怀服务仍需加强。建议了一些进一步研究的重点领域。
