迈向社会-精神方法?对处于疾病终末期患者的社会和精神需求的混合方法系统评价。
Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness.
机构信息
Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands.
Academic Hospice Demeter, De Bilt, the Netherlands.
出版信息
Palliat Med. 2021 Jun;35(6):1071-1098. doi: 10.1177/02692163211010384. Epub 2021 Apr 20.
BACKGROUND
Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients' expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions.
AIM
To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature.
DESIGN
A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571).
DATA SOURCES
The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients' perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools.
RESULTS
Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death.
CONCLUSION
What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients' linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients' needs and enables interdisciplinary teamwork to allocate patient-tailored care.
背景
患者表达了各种需求,其中一些被标记为社会和精神需求。如果不深入探讨患者对这些需求的表达,就很难对它们进行区分,并分配适当的医疗干预措施。
目的
深入了解患有绝症的患者的社会和精神需求,以及这些需求在研究文献中的区别。
设计
采用循证卫生保健中心(JBI)定性综合方法和 PALETTE 框架进行混合方法系统评价和元综合,并按照 PRISMA 声明进行报告。该综述在 PROSPERO(CRD42019133571)中进行了注册。
数据来源
在 PubMed、EMBASE、CINAHL、Scopus 和 PsycInfo 中进行了检索。符合条件的研究报告了从患者角度出发的社会和精神需求,发表时间为 2008 年 1 月 1 日至 2020 年 10 月。使用 JBI 批判性评价工具评估证据质量。
结果
共纳入 34 项研究(19 项定性研究、1 项混合方法研究和 14 项定量研究)。包括社会和精神需求的五个综合发现是:自主、联系、寻找和赋予意义、积极的人生观和应对死亡。
结论
文献中标记为社会和精神需求的内容显示出很大的相似性和重叠。不应该仅仅根据患者的语言表达来区分社会需求和精神需求,而应该深入探讨需求。我们提出了一种社会精神方法,既尊重和保留患者需求的多维性,又能使跨学科团队为患者提供量身定制的护理。