Dumont Katia, Marcoux Isabelle, Warren Émilie, Alem Farah, Alvar Bea, Ballu Gwenvaël, Bostock Anitra, Cohen S Robin, Daneault Serge, Dubé Véronique, Houle Janie, Minyaoui Asma, Rouly Ghislaine, Weil Dale, Kellehear Allan, Boivin Antoine
Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada.
Faculty of Health Sciences, University of Ottawa, 25 University Street, office 206, Ottawa, K1N 6N5, Canada.
BMC Palliat Care. 2022 Jul 20;21(1):131. doi: 10.1186/s12904-022-01021-3.
Compassionate communities are rooted in a health promotion approach to palliative care, aiming to support solidarity among community members at the end of life. Hundreds of compassionate communities have been developed internationally in recent years. However, it remains unknown how their implementation on the ground aligns with core strategies of health promotion. The aim of this review is to describe the practical implementation and evaluation of compassionate communities.
We undertook a scoping review of the empirical peer-reviewed literature on compassionate communities. Bibliographic searches in five databases were developed with information specialists. We included studies in English describing health promotion activities applied to end-of-life and palliative care. Qualitative analysis used inductive and deductive strategies based on existing frameworks for categorization of health promotion activities, barriers and facilitators for implementation and evaluation measures. A participatory research approach with community partners was used to design the review and interpret its findings.
Sixty-three articles were included for analysis. 74.6% were published after 2011. Health services organizations and providers are most often engaged as compassionate community leaders, with community members mainly engaged as target users. Adaptation to local culture and social context is the most frequently reported barrier for implementation, with support and external factors mostly reported as facilitators. Early stages of compassionate community development are rarely reported in the literature (stakeholder mobilization, needs assessment, priority-setting). Health promotion strategies tend to focus on the development of personal skills, mainly through the use of education and awareness programs. Few activities focused on strengthening community action and building healthy public policies. Evaluation was reported in 30% of articles, 88% of evaluation being analyzed at the individual level, as opposed to community processes and outcomes.
The empirical literature on compassionate communities demonstrates a wide variety of health promotion practices. Much international experience has been developed in education and awareness programs on death and dying. Health promotion strategies based on community strengthening and policies need to be consolidated. Future research should pay attention to community-led initiatives and evaluations that may not be currently reported in the peer-review literature.
关爱社区植根于姑息治疗的健康促进方法，旨在支持社区成员在生命末期的团结。近年来，国际上已发展出数百个关爱社区。然而，它们在实际中的实施与健康促进的核心策略如何契合仍不明确。本综述的目的是描述关爱社区的实际实施与评估情况。
我们对关于关爱社区的实证同行评审文献进行了范围综述。与信息专家合作在五个数据库中进行了文献检索。我们纳入了用英文描述应用于临终和姑息治疗的健康促进活动的研究。定性分析采用基于现有健康促进活动分类框架、实施障碍和促进因素以及评估措施的归纳和演绎策略。采用与社区伙伴的参与式研究方法来设计综述并解读研究结果。
纳入63篇文章进行分析。74.6%的文章于2011年后发表。卫生服务组织和提供者最常作为关爱社区的领导者参与其中，社区成员主要作为目标用户参与。适应当地文化和社会背景是实施过程中最常报告的障碍，支持和外部因素大多被报告为促进因素。关爱社区发展的早期阶段在文献中很少被报道（利益相关者动员、需求评估、确定优先事项）。健康促进策略往往侧重于个人技能的发展，主要通过教育和提高认识项目来实现。很少有活动侧重于加强社区行动和制定健康的公共政策。30%的文章报告了评估情况，88%的评估是在个体层面进行分析的，而非社区过程和结果层面。
关于关爱社区的实证文献展示了各种各样的健康促进实践。在死亡和临终教育及提高认识项目方面已经积累了很多国际经验。基于社区强化和政策的健康促进策略需要得到巩固。未来的研究应关注社区主导的倡议以及同行评审文献中目前可能未报道的评估情况。
