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欧洲针对老年心血管疾病患者家庭的医疗保健实践与干预措施:一项范围综述。

Healthcare practices and interventions in Europe towards families of older patients with cardiovascular disease: A scoping review.

作者信息

Mahrer-Imhof Romy, Østergaard Birte, Brødsgaard Anne, Konradsen Hanne, Svavarsdóttir Erla Kolbrun, Dieperink Karin B, Imhof Lorenz, García-Vivar Cristina, Luttik Marie-Louise

机构信息

Family-Centred and Community-Based Care, Nursing Science & Care Ltd, Basel, Switzerland.

Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Scand J Caring Sci. 2022 Jun;36(2):320-345. doi: 10.1111/scs.13045. Epub 2021 Nov 17.

Abstract

BACKGROUND

In Europe, cardiovascular disease is one of the predominant causes of mortality and morbidity among older people over 65 years. The occurrence of cardiovascular disease can have a negative impact on the quality of life of older patients and their families and family health overall. Assuming that illness is a family affair shaped by culture and health care systems, we explored European health care practices and interventions toward families of older patients with cardiovascular disease and heart failure.

AIMS

This paper aimed to determine the extent, range, and variety of practices and interventions in Europe directed to families of older patients and to identify knowledge gaps.

MATERIALS & METHODS: A scoping review was conducted including studies published in Medline, CINHAL, or Cochrane library between 2009 and mid-2020.

RESULTS

A total of 22 articles from 17 studies were included, showing diverse practices and interventions. The interventions targeted the family as a unit (six studies), dyads (five studies), patients alone, but assessed family members' reactions (five studies) or the family member primarily, but assessed the reaction of the patient (one study). Target outcomes were family caregiver burden; health-related QoL; and perceived control in patients; and family functioning and changes in health behavior or knowledge in both, family members and patients. Most studies did not include an integral view of the family as the unit of care but rather had a disease-centered approach.

DISCUSSION

This scoping review provides insight into a variety of healthcare practices towards families of older patients with cardiovascular disease in Europe. Clarifying underlying assumptions to involve families is needed. More studies with family-focused approaches as integral models could lead to practices that improve families' well-being. Exploring integral models for their acceptance in health care and family systems appears pertinent to develop European policy to support and add to family health.

摘要

背景

在欧洲,心血管疾病是65岁以上老年人死亡和发病的主要原因之一。心血管疾病的发生会对老年患者及其家庭的生活质量以及整体家庭健康产生负面影响。假设疾病是由文化和医疗保健系统塑造的家庭事务,我们探讨了欧洲针对老年心血管疾病和心力衰竭患者家庭的医疗保健实践与干预措施。

目的

本文旨在确定欧洲针对老年患者家庭的实践与干预措施的范围、广度和种类,并找出知识空白。

材料与方法

进行了一项范围综述,纳入2009年至2020年年中发表在Medline、CINHAL或Cochrane图书馆的研究。

结果

共纳入17项研究中的22篇文章,显示出多样的实践与干预措施。这些干预措施将家庭作为一个整体(6项研究)、二元组(5项研究)、仅针对患者但评估家庭成员反应(5项研究)或主要针对家庭成员但评估患者反应(1项研究)。目标结果包括家庭照顾者负担;与健康相关的生活质量;患者的感知控制;以及家庭功能以及家庭成员和患者健康行为或知识的变化。大多数研究没有将家庭作为护理单位进行整体考量,而是采用以疾病为中心的方法。

讨论

这项范围综述深入了解了欧洲针对老年心血管疾病患者家庭的各种医疗保健实践。需要明确让家庭参与的潜在假设。更多以家庭为重点的研究作为整体模式可能会带来改善家庭福祉的实践。探索整体模式在医疗保健和家庭系统中的接受度似乎与制定支持和增进家庭健康的欧洲政策相关。

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