1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
2 Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Palliat Med. 2018 Sep;32(8):1305-1321. doi: 10.1177/0269216318784474. Epub 2018 Jun 29.
Advance care planning is seen as an important strategy to improve end-of-life communication and the quality of life of patients and their relatives. However, the frequency of advance care planning conversations in practice remains low. In-depth understanding of patients' experiences with advance care planning might provide clues to optimise its value to patients and improve implementation.
To synthesise and describe the research findings on the experiences with advance care planning of patients with a life-threatening or life-limiting illness.
A systematic literature review, using an iterative search strategy. A thematic synthesis was conducted and was supported by NVivo 11.
The search was performed in MEDLINE, Embase, PsycINFO and CINAHL on 7 November 2016.
Of the 3555 articles found, 20 were included. We identified three themes in patients' experiences with advance care planning. 'Ambivalence' refers to patients simultaneously experiencing benefits from advance care planning as well as unpleasant feelings. 'Readiness' for advance care planning is a necessary prerequisite for taking up its benefits but can also be promoted by the process of advance care planning itself. 'Openness' refers to patients' need to feel comfortable in being open about their preferences for future care towards relevant others.
Although participation in advance care planning can be accompanied by unpleasant feelings, many patients reported benefits of advance care planning as well. This suggests a need for advance care planning to be personalised in a form which is both feasible and relevant at moments suitable for the individual patient.
预先医疗照护计划被视为改善末期病患及其家属之临终沟通与生活品质的重要策略。然而，实务中预先医疗照护计划的讨论频率仍然偏低。深入了解病患对于预先医疗照护计划的经验可能提供线索以优化其对病患的价值，并改善其施行。
综合并描述患有危及生命或生命有限疾病之病患对于预先医疗照护计划经验的研究发现。
系统文献回顾，使用迭代式搜寻策略。进行主题式综合，并以 NVivo 11 辅助。
2016 年 11 月 7 日在 MEDLINE、Embase、PsycINFO 和 CINAHL 进行检索。
在 3555 篇文章中，有 20 篇被纳入。我们在病患对于预先医疗照护计划的经验中识别出三个主题。“矛盾心理”指的是病患同时体验到预先医疗照护计划的益处以及不愉快的感觉。“准备就绪”是接受预先医疗照护计划益处的必要前提条件，但也可透过预先医疗照护计划本身的过程来促进。“开放性”指的是病患需要对相关他人感到自在地公开其对于未来照护的偏好。
虽然参与预先医疗照护计划可能伴随着不愉快的感觉，但许多病患也报告了预先医疗照护计划的益处。这表明预先医疗照护计划需要以对个体病患而言既可行又相关的方式进行个性化。
