School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK.
Nottingham Centre for the Advancement of Research into Supportive, Palliative and End-of-Life Care (NCARE), School of Health Sciences, University of Nottingham, Nottingham, UK.
Vet Rec. 2022 Aug;191(4):e1730. doi: 10.1002/vetr.1730. Epub 2022 Jun 15.
End-of-life decisions for companion animals can be stressful for veterinarians and owners, and when delayed result in poor animal welfare. Delayed euthanasia has been identified as a particularly prominent issue for horses. This scoping review aimed to identify the available literature on veterinary decision-making models, which can support end-of-life planning.
A protocol was preregistered, and a structured literature search was performed on six electronic databases. Publications were reviewed against specifically developed eligibility criteria. Data from original studies and narrative-type reviews were extracted separately, and the components of each model were charted.
A total of 2211 publications were identified, 23 met the inclusion criteria and were included in the final review. Eight were original research studies and 15 were narrative reviews or similar. Publications were not indexed uniformly, increasing the difficulty of discovering relevant sources. The end-of-life decision-making process comprised three stages: (1) making the decision, (2) enacting the decision and (3) aftercare. Twenty key components of decision-making models were identified, although no publication reflected all of these.
A lack of original research studies and equine-specific publications was identified. Shared decision-making models for euthanasia in veterinary practice should include all three stages and consider species-specific issues.
为宠物动物做出临终决策可能会给兽医和主人带来压力,而如果决策延迟则会导致动物福利不佳。对于马来说,延迟实施安乐死已经成为一个特别突出的问题。本范围综述旨在确定现有的关于兽医决策模型的文献,这些模型可以支持临终规划。
制定了一份方案,并在六个电子数据库中进行了结构化文献检索。根据专门制定的资格标准对出版物进行了审查。从原始研究和叙述性综述中分别提取数据,并对每个模型的组成部分进行图表绘制。
共确定了 2211 篇出版物,其中 23 篇符合纳入标准并包含在最终综述中。其中 8 篇是原始研究,15 篇是叙述性综述或类似文章。出版物没有统一索引,增加了发现相关来源的难度。临终决策过程包括三个阶段:(1)做出决策,(2)执行决策,(3)善后。确定了 20 个决策模型的关键组成部分,但没有一篇出版物反映了所有这些内容。
确定了缺乏原始研究和专门针对马的出版物的问题。兽医实践中安乐死的共同决策模型应包括所有三个阶段,并考虑到特定于物种的问题。