Advance Care Planning Australia, Austin Health, Melbourne, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia.
Advance Care Planning Australia, Austin Health, Melbourne, Australia.
J Pain Symptom Manage. 2019 Jun;57(6):1166-1175.e1. doi: 10.1016/j.jpainsymman.2019.02.031. Epub 2019 Mar 8.
Volunteer involvement may support organizations to initiate and operationalize complex interventions such as advance care planning (ACP).
A scoping review was conducted to map existing research on volunteer involvement in ACP and to identify gaps in current knowledge base.
We followed the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines. The review included studies of any design reporting original research. ACP was defined as any intervention aimed at supporting people to consider and communicate their current and future health treatment goals in the context of their own preferences and values. Studies were included if they reported data relating to volunteers at any stage in the delivery of ACP.
Of 11 studies identified, nine different ACP models (initiatives to improve uptake of ACP) were described. Most of the models involved volunteers facilitating ACP conversations or advance care directive completion (n = 6); and three focused on ACP education, training, and support. However, a framework for volunteer involvement in ACP was not described; the studies often provided limited detail of the scope of volunteers' roles in ACP, and in three of the models, volunteers delivered ACP initiatives in addition to undertaking other tasks, in their primary role as a volunteer navigator. Increased frequency of ACP conversation or documentation was most commonly used to evaluate the effectiveness of the studies, with most showing a trend toward improvement.
Current literature on volunteer involvement in ACP is lacking a systematic approach to implementation. We suggest future research should focus on person-centered outcomes related to ACP to evaluate the effectiveness of volunteer involvement.
志愿者的参与可以支持组织启动和实施复杂的干预措施，如预先医疗指示（ACP）。
进行了范围综述，以绘制现有关于志愿者参与 ACP 的研究，并确定当前知识基础中的差距。
我们遵循了扩展的 PRISMA 用于范围综述（PRISMA-ScR）指南。该综述包括报告原始研究的任何设计的研究。ACP 被定义为任何旨在支持人们在自己的偏好和价值观背景下考虑和传达他们当前和未来的医疗治疗目标的干预措施。如果研究报告了与 ACP 提供过程中的任何阶段的志愿者相关的数据，则将其纳入研究。
在确定的 11 项研究中，描述了 9 种不同的 ACP 模式（旨在提高 ACP 的采用率）。大多数模式涉及志愿者促进 ACP 对话或预先医疗指示的完成（n=6）；有三个模式专注于 ACP 教育、培训和支持。然而，没有描述志愿者参与 ACP 的框架；这些研究通常提供了志愿者在 ACP 中的角色范围的有限细节，在三个模式中，志愿者在其作为志愿导航员的主要角色之外，还开展了 ACP 倡议。评估研究效果最常用的是增加 ACP 对话或文档的频率，大多数研究都显示出改善的趋势。
目前关于志愿者参与 ACP 的文献缺乏系统的实施方法。我们建议未来的研究应侧重于与 ACP 相关的以人为本的结果，以评估志愿者参与的效果。
