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慢性阻塞性肺疾病和预先护理计划:对患者体验的定性文献的综合分析。

Chronic obstructive pulmonary disease and advance care planning: A synthesis of qualitative literature on patients' experiences.

机构信息

School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.

Nepean Blue Mountains Local Health District, Penrith, NSW, Australia.

出版信息

Chronic Illn. 2022 Jun;18(2):221-233. doi: 10.1177/1742395321990109. Epub 2021 Feb 11.

Abstract

OBJECTIVE

Advance Care Planning supports patients to share their personal values, goals, and preferences for future medical care with their family members and healthcare professionals. The aim of this review was to uncover what is known about patients with Chronic Obstructive Pulmonary Disease and their experiences with Advance Care Planning.

METHODS

A systematic review and thematic synthesis of qualitative studies was undertaken. Five databases were searched for qualitative articles published between 2009-2019. The review was guided by the PRISMA framework and seven studies met the eligibility criteria. Thematic synthesis of descriptive themes in each article was undertaken to develop overarching analytical themes, related to the experience of patients with Chronic Obstructive Pulmonary Disease and Advance Care Planning.

RESULTS

Four analytical themes emerged from the review of the articles that met the inclusion criteria: patient readiness and willingness for Advance Care Planning discussions; considering the future; trusted relationships with healthcare professionals; and shared decision making.

DISCUSSION

Patients with Chronic Obstructive Pulmonary Disease are generally open to Advance Care Planning discussions with healthcare professionals who are well-informed, and trusted by the patient. Models of care that integrate Advance Care Planning are beneficial in other non-malignant settings, and may be a way forward to support Advance Care Planning as part of routine care for patients with Chronic Obstructive Pulmonary Disease.

摘要

目的

预先医疗照护计划有助于患者与其家属和医疗保健专业人员分享他们对未来医疗的个人价值观、目标和偏好。本研究旨在揭示慢性阻塞性肺疾病患者的情况及其对预先医疗照护计划的体验。

方法

对 2009 年至 2019 年期间发表的定性研究进行了系统评价和主题综合分析。在五个数据库中搜索定性文章。该综述遵循 PRISMA 框架,有七项研究符合入选标准。对每篇文章中描述性主题的主题综合分析,制定了与慢性阻塞性肺疾病患者和预先医疗照护计划体验相关的总体分析主题。

结果

从符合纳入标准的文章中得出了四个分析主题:患者对预先医疗照护计划讨论的准备和意愿;考虑未来;与医疗保健专业人员建立信任关系;以及共同决策。

讨论

慢性阻塞性肺疾病患者通常愿意与了解情况并得到患者信任的医疗保健专业人员进行预先医疗照护计划的讨论。将预先医疗照护计划纳入护理模式在其他非恶性疾病环境中是有益的,并且可能是支持将预先医疗照护计划作为慢性阻塞性肺疾病患者常规护理一部分的一种方式。

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