1 School of Nursing, Fujian Medical University, Fuzhou, China.
2 Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Palliat Med. 2018 Jul;32(7):1167-1179. doi: 10.1177/0269216318772267. Epub 2018 Apr 30.
Terminal illness not only causes physical suffering but also spiritual distress. Spiritual care has been widely implemented by healthcare professionals to assist patients coping with spiritual distress. However, the effects of spiritual care need to be clear.
To evaluate the effects of spiritual care on quality of life and spiritual well-being among patients with terminal illness.
Systematic review according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance.
A comprehensive search was conducted in nine electronic databases from date of inception to May 2017. Hand searches of the bibliographies of relevant articles were also performed. The studies were independently reviewed by two investigators who scored them for methodological quality using the Cochrane Risk of Bias Tool.
No statistical pooling of outcomes was performed and a narrative summary was chosen to describe the included studies. A total of 19 studies with 1548 participants were identified in the systematic review, corresponding to seven kinds of interventions. The risk of bias for these studies were all rated as moderate. A majority of studies indicated that spiritual care had a potential beneficial effect on quality of life and spiritual well-being among patients with terminal illness.
It is suggested that healthcare professionals integrate spiritual care with usual care in palliative care. When providing spiritual care, healthcare professionals should take into consideration patients' spiritual needs, preference, and cultural background. More multicenter and disciplinary studies with rigorous designs are needed in the future.
终末期疾病不仅会带来身体上的痛苦，还会带来精神上的困扰。精神关怀已被医护人员广泛应用于帮助患者应对精神困扰。然而，精神关怀的效果尚需明确。
评价精神关怀对终末期疾病患者生活质量和精神健康的影响。
按照系统评价和荟萃分析建议的报告条目进行系统综述。
从各数据库建库开始至 2017 年 5 月进行了全面检索，还对相关文章的参考文献进行了手工检索。由两名评价员独立评价研究的方法学质量，采用 Cochrane 偏倚风险工具进行评价。
由于无法进行结局的统计学合并，故选择进行描述性综述来呈现纳入的研究。系统综述共纳入 19 项研究，共计 1548 例患者，涉及 7 种干预措施。这些研究的偏倚风险均被评为中度。大多数研究表明，精神关怀对终末期疾病患者的生活质量和精神健康具有潜在的有益影响。
建议医护人员将精神关怀与姑息治疗中的常规护理相结合。提供精神关怀时，医护人员应考虑患者的精神需求、偏好和文化背景。未来需要开展更多设计严谨的多中心和多学科研究。
