Kim Kyounghae, Heinze Katherine, Xu Jiayun, Kurtz Melissa, Park Hyunjeong, Foradori Megan, Nolan Marie T
1 University of Connecticut, Storrs, USA.
2 Johns Hopkins University, Baltimore, MD, USA.
West J Nurs Res. 2018 Dec;40(12):1861-1884. doi: 10.1177/0193945917723010. Epub 2017 Aug 17.
The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models ( n = 14) followed by family-centered ( n = 11) and behavioral change models ( n = 7). A conceptual framework was developed using themes including context of decision making, communication and negotiation of decision making, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision making at the end of life among patients with advanced illness and their caregivers.
这项元民族志研究的目的是评估与临终决策相关的理论类型及应用，并构建一个概念框架，以描述晚期癌症、心力衰竭和肌萎缩侧索硬化症（ALS）患者及其护理人员或医疗服务提供者的临终决策过程。我们使用PubMed、Embase和护理及相关健康文献累积索引（CINAHL）数据库，检索2002年1月至2015年4月期间发表的英文文章。共纳入43篇文章。最常见的理论包括决策模型（n = 14），其次是家庭中心理论（n = 11）和行为改变模型（n = 7）。利用包括决策背景、决策的沟通与协商、决策者特征、决策目标、选择和替代方案以及结果等主题，构建了一个概念框架。未来的研究应加强并应用这些理论，以指导开展以患者为中心的决策项目的研究，从而促进晚期疾病患者及其护理人员在临终时进行知情和共同决策。
