Department of Nursing and Podiatry, University of Málaga, Spain; Biomedical Research Institute of Málaga (IBIMA), Spain.
Biomedical Research Institute of Málaga (IBIMA), Spain; Cudeca Foundation, Málaga, Spain.
Int J Nurs Stud. 2020 Oct;110:103704. doi: 10.1016/j.ijnurstu.2020.103704. Epub 2020 Jul 10.
The relief of suffering is considered one of the main goals to reach at the end of life, and nurses play an essential role in the prevention and relief of suffering. Validated instruments for assessing suffering can be useful, and selection of the most appropriate measure is crucial. To date, no systematic review has been performed that contrasts the measurement properties of instruments assessing suffering in the palliative care population, according to the most up-to-date COnsensus-based Standards for the selection of health status Measurement INstruments methodology.
The aim of this systematic review is twofold: (1) identify the measures assessing suffering in the palliative care population, and (2) assess the measurement properties of these measures.
A systematic review of the measurement properties of instruments assessing suffering in palliative care was carried out.
The search strategy was conducted in Medline, CINAHL, PsycINFO, Web of Science, Cochrane Library, SciELO, Scopus, Cosmin database of systematic reviews and Open gray.
The following methodologies were applied: updated COnsensus-based Standards for the selection of health status Measurement INstruments, the Meta-Analysis of Observational Studies in Epidemiology, and the Assessing the Methodological Quality of Systematic Reviews tool. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42018106488). Eligible studies were those that satisfied the following criteria: a) validation studies of measures assessing suffering in the palliative care population, b) assessing at least one measurement property of a measure, c) published in English or Spanish and d) published between January 1980 and September 2019. The included studies were assessed for the methodological quality of the measurement properties and then compared in terms of both the measurement properties and the methodological quality of the processes used. The evidence for each measurement property was summarised and the quality of the evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluation approach.
The search strategy yielded a total of nine studies and six instruments assessing suffering. The methodological quality of the studies was doubtful and the quality of the evidence was moderate for most of the measurement properties analysed. The Suffering Pictogram was the instrument with the best rating for methodological quality and quality of evidence, for most of the measurement properties evaluated.
Instruments assessing suffering in palliative care have been identified in this systematic review. The Suffering Pictogram seems to be the most useful instrument identified. Tweetable abstract: The relief of suffering is one of the main goals to reach at the end of life, and the selection of the most appropriate measure for assessing this construct is crucial.
缓解痛苦被认为是临终关怀的主要目标之一，护士在预防和缓解痛苦方面发挥着重要作用。经过验证的评估痛苦的工具可能会很有用，选择最合适的测量方法至关重要。迄今为止，根据最新的基于共识的健康状况测量工具选择标准，还没有进行过系统评价来对比评估姑息治疗人群中痛苦的工具的测量特性。
本系统评价的目的有两个：(1)确定评估姑息治疗人群中痛苦的测量工具；(2)评估这些测量工具的测量特性。
对评估姑息治疗中痛苦的工具的测量特性进行了系统评价。
在 Medline、CINAHL、PsycINFO、Web of Science、Cochrane 图书馆、SciELO、Scopus、Cosmin 系统评价数据库和 Open gray 中进行了搜索策略。
应用了以下方法：更新的基于共识的健康状况测量工具选择标准、观察性研究的荟萃分析和系统评价方法学质量评估工具。本系统评价的方案已在 PROSPERO 中注册（注册号：CRD42018106488）。符合以下标准的研究为合格研究：(1)评估姑息治疗人群中痛苦的测量工具的验证研究，(2)评估至少一个测量工具的测量特性，(3)发表在英语或西班牙语，(4)发表在 1980 年 1 月至 2019 年 9 月期间。对纳入的研究进行了测量特性的方法学质量评估，然后根据测量特性和使用的过程的方法学质量进行了比较。总结了每个测量特性的证据，并使用推荐评估、开发和评估方法对证据质量进行了分级。
搜索策略共产生了九项研究和六种评估痛苦的工具。研究的方法学质量是可疑的，对于分析的大多数测量特性，证据质量为中等。 Suffering Pictogram 在评估的大多数测量特性中具有最佳的方法学质量和证据质量评分。
本系统评价确定了姑息治疗中评估痛苦的工具。 Suffering Pictogram 似乎是最有用的工具。可推文摘要：缓解痛苦是临终关怀的主要目标之一，选择最合适的评估工具至关重要。
