Bornet Marc-Antoine, Bernard Mathieu, Jaques Cécile, Rubli Truchard Eve, Borasio Gian Domenico, Jox Ralf J
Chair of Geriatric Palliative Care, Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
J Pain Symptom Manage. 2021 Apr;61(4):845-857.e18. doi: 10.1016/j.jpainsymman.2020.09.012. Epub 2020 Sep 12.
The will to live (WTL) is an important factor to consider in the context of providing resource-oriented palliative care. Until now, there has been no major review of the existing research on this subject.
The primary objective of this study is to summarize the state of research concerning instruments that assess the WTL. The secondary objective is to explore the theoretical models and psychometric properties of these instruments, in studies where these instruments were initially presented. The tertiary objective is to identify, among all studies where these instruments have been used, the intensity of the WTL, and factors associated with it.
We conducted a scoping review, including studies that were designed to assess the WTL among participants in all settings. Records were systematically searched from seven bibliographic databases with no date limitations up to August 2020.
Of the 3078 records screened, 281 were examined in detail and 111 were included in the synthesis. A total of 25 different instruments quantitatively assessing the WTL are presented. Most are single-question tools and rate intensity. The underlying concepts and psychometric properties are incompletely explained. Lack of crossreferencing is apparent. The intensity of the WTL is high, even among people with significant health impairment, and is frequently associated with different factors, such as resilience and quality of life.
A considerable yet unconnected body of studies assesses the WTL. Its assessment in clinical routine could promote resource-oriented and patient-centered care.
求生意愿（WTL）是提供以资源为导向的姑息治疗时需要考虑的一个重要因素。到目前为止，尚未对该主题的现有研究进行过全面综述。
本研究的主要目的是总结有关评估求生意愿的工具的研究现状。次要目的是在这些工具最初被提出的研究中，探讨其理论模型和心理测量特性。第三个目的是在所有使用这些工具的研究中，确定求生意愿的强度及其相关因素。
我们进行了一项范围综述，纳入了旨在评估所有环境中参与者求生意愿的研究。从7个书目数据库中系统检索记录，检索时间截至2020年8月，无日期限制。
在筛选出的3078条记录中，281条进行了详细审查，111条纳入了综述。共介绍了25种定量评估求生意愿的不同工具。大多数是单问题工具并对强度进行评分。其潜在概念和心理测量特性解释不完整。明显缺乏相互参照。即使在健康状况严重受损的人群中，求生意愿的强度也很高，并且经常与不同因素相关，如复原力和生活质量。
大量但相互独立的研究对求生意愿进行了评估。在临床常规中对其进行评估可促进以资源为导向和以患者为中心的护理。
