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智力残疾患者获得姑息治疗的障碍:范围综述。

Barriers to Palliative Care Access in Patients With Intellectual Disability: A Scoping Review.

机构信息

Department of Health Sciences (J.V.I., P.B.S.), Universidad Técnica Particular de Loja (UTPL), Loja, Ecuador.

Department of Health Sciences (J.V.I., P.B.S.), Universidad Técnica Particular de Loja (UTPL), Loja, Ecuador.

出版信息

J Pain Symptom Manage. 2022 Dec;64(6):e347-e356. doi: 10.1016/j.jpainsymman.2022.08.007. Epub 2022 Aug 19.

DOI:10.1016/j.jpainsymman.2022.08.007
PMID:35995282
Abstract

UNLABELLED

There is limited knowledge about inequalities regarding palliative care access among patients with intellectual disability. The present scoping review aimed to identify the existing barriers that limit access to palliative care (PC) in patients with intellectual disability.

METHODS

We conducted a literature review on publications since 2014 from three databases (MEDLINE, Biomed Central, and Elsevier Scopus), along with hand searches in scientific journals. The review included peer-reviewed studies written in English and Spanish language with quantitative and qualitative study designs. The participants were patients with intellectual disability and health professionals who had worked with them or had experience in palliative care.

RESULTS

22 studies met the selection criteria. The barriers identified were under referral to palliative care, reduced access, communication, and limited knowledge and experience by health professionals.

CONCLUSION

Patients with intellectual disability do not get referred to PC frequently. Health professionals and caregivers do not recognize when it is necessary to make a referral, and they need to improve their communication abilities. Also, health care workers need more training in PC, pain management, anticipation of death, and use of opioids. More research and education on the palliative care needs and care for patients with intellectual disabilities is needed.

摘要

背景

关于智障患者获得姑息治疗的机会存在不平等现象,相关知识有限。本研究旨在明确限制智障患者获得姑息治疗(PC)的现有障碍。

方法

我们检索了 2014 年以来 MEDLINE、Biomed Central 和 Elsevier Scopus 三个数据库以及科学杂志中的手工检索文献,纳入了发表在同行评审期刊上的英文和西班牙文的定量和定性研究。参与者为智障患者和曾与其接触或有姑息治疗经验的卫生专业人员。

结果

22 项研究符合选择标准。确定的障碍包括向姑息治疗机构转介不足、获得机会减少、沟通障碍以及卫生专业人员知识和经验有限。

结论

智障患者没有经常被转介到姑息治疗机构。卫生专业人员和护理人员没有意识到何时需要转介,他们需要提高沟通能力。此外,卫生保健工作者需要接受姑息治疗、疼痛管理、死亡预期和阿片类药物使用方面的更多培训。需要进一步研究和教育智障患者姑息治疗的需求和护理。

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