Research Centre Innovations in Care, Rotterdam University of Applied Sciences, the Netherlands; Department of Public Health, Erasmus University Medical Center Rotterdam, the Netherlands.
Department of Public Health, Erasmus University Medical Center Rotterdam, the Netherlands.
Int J Nurs Stud. 2019 Sep;97:28-39. doi: 10.1016/j.ijnurstu.2019.04.011. Epub 2019 Apr 23.
Family caregivers are crucial in end-of-life care. However, family caregiving may involve a significant burden with various negative health consequences. Although nurses are in a unique position to support family caregivers at home, little is known about which nursing interventions are effective in this context. Therefore, this study aims to provide insight into nursing interventions currently available to support family caregivers in end-of-life care at home and to describe their effects.
A systematic search was conducted in Embase, Medline Ovid, Web of Science, Cochrane Central, CINAHL and Google Scholar. This review included quantitative studies published from January 2003 until December 2018 reporting on nursing interventions to support adult family caregivers in end-of-life care at home. Data were extracted on intervention modalities, intervention components, and family caregivers' outcomes. Methodological quality of the studies was assessed with the Cochrane Risk of Bias Tool.
Out of 1531 titles, nine publications were included that reported on eight studies/eight interventions. Of the eight studies, three were randomised controlled trials, one a pilot randomised trial, one a non-randomised trial, and three were single-group prospective studies. Four intervention components were identified: psychoeducation, needs assessment, practical support with caregiving, and peer support. Psychoeducation was the most commonly occurring component. Nursing interventions had a positive effect on the preparedness, competence, rewards, and burden of family caregivers. Multicomponent interventions were the most effective with, potentially, the components 'needs assessment' and 'psychoeducation' being the most effective.
Although only eight studies are available on nursing interventions to support family caregivers in end-of-life care at home, they show that interventions can have a positive effect on family caregivers' outcomes. Multicomponent interventions proved to be the most successful, implying that nurses should combine different components when supporting family caregivers.
在临终关怀中，家庭护理人员是至关重要的。然而，家庭护理可能会带来很大的负担，并对健康产生各种负面影响。尽管护士在家中为家庭护理人员提供支持的位置独特，但对于哪些护理干预措施在这种情况下有效知之甚少。因此，本研究旨在深入了解目前可用于支持家庭护理人员在家中进行临终关怀的护理干预措施，并描述其效果。
对 Embase、Medline Ovid、Web of Science、Cochrane 中心、CINAHL 和 Google Scholar 进行了系统检索。本综述纳入了 2003 年 1 月至 2018 年 12 月期间发表的报告针对在家中接受临终关怀的成年家庭护理人员的护理干预措施的定量研究。提取干预方式、干预内容和家庭护理人员结果的数据。使用 Cochrane 偏倚风险工具评估研究的方法学质量。
在 1531 篇标题中，有 9 篇出版物被纳入，其中报道了 8 项研究/8 项干预措施。在这 8 项研究中，有 3 项为随机对照试验，1 项为随机试验，1 项为非随机试验，3 项为单组前瞻性研究。确定了 4 个干预组成部分：心理教育、需求评估、护理支持、同伴支持。心理教育是最常见的组成部分。护理干预对家庭护理人员的准备情况、能力、奖励和负担产生了积极影响。多组分干预措施最有效，潜在地，“需求评估”和“心理教育”这两个组成部分最有效。
尽管仅有 8 项关于支持家庭护理人员在家中进行临终关怀的护理干预措施的研究，但它们表明干预措施可以对家庭护理人员的结果产生积极影响。多组分干预措施被证明是最成功的，这意味着护士在支持家庭护理人员时应结合使用不同的组分。
