Frey Rosemary, Balmer Deborah
School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
WA Centre for Rural Health, The University of Western Australia, Geraldton, Australia.
Palliat Support Care. 2024 Aug;22(4):827-839. doi: 10.1017/S1478951523000275.
The growing demand for palliative care has been accelerated due to the COVID-19 pandemic. However, providing community-based palliative care was also more difficult to do safely and faced several challenges. The goal of this integrative review was to identify, describe, and synthesize previous studies on the challenges for health professionals delivering palliative care in the community during the COVID-19 pandemic.
Searches were carried out on the Ovid MEDLINE, CINAHL, PsycINFO, Social Care Online, PubMed, Embase, and Expanded Academic databases. Journals typically reporting palliative care and community health studies were also searched (, and ). All articles were peer-reviewed and published in English between December 2019 and September 2022.
Database and hand searches identified 1231 articles. After duplicates were removed and the exclusion criteria applied, 27 articles were included in the final review. Themes in the research findings centered on 6 interconnected categories. The challenges imposed by the pandemic (lack of resources, communication difficulties, access to education and training, and interprofessional coordination), as well as the varying levels of success of the health-care responses, impacted the well-being of health professionals and, in turn, the well-being and care of patients and families.
The pandemic has provided the impetus for rethinking flexible and innovative approaches to overcome the challenges of delivering community palliative care. However, existing governmental and organizational policies require revision to improve communication and effective interprofessional collaboration, and additional resources are needed. A blended model of virtual and in-person palliative care delivery may provide the best solution to community palliative care delivery moving forward.
由于新冠疫情，对姑息治疗的需求日益增长且加速。然而，提供基于社区的姑息治疗在安全实施方面也更加困难，并面临诸多挑战。本整合性综述的目的是识别、描述和综合以往关于新冠疫情期间卫生专业人员在社区提供姑息治疗所面临挑战的研究。
在Ovid MEDLINE、CINAHL、PsycINFO、Social Care Online、PubMed、Embase和Expanded Academic数据库中进行检索。还检索了通常报道姑息治疗和社区卫生研究的期刊（以及 ）。所有文章均经过同行评审，并于2019年12月至2022年9月期间以英文发表。
数据库检索和手工检索共识别出1231篇文章。在去除重复项并应用排除标准后，最终综述纳入了27篇文章。研究结果中的主题集中在6个相互关联的类别上。疫情带来的挑战（资源短缺、沟通困难、获得教育和培训的机会以及跨专业协作），以及医疗应对措施的不同程度的成效，影响了卫生专业人员的福祉，进而影响了患者及其家庭的福祉和护理。
疫情促使人们重新思考灵活和创新的方法来克服提供社区姑息治疗的挑战。然而，现有的政府和组织政策需要修订，以改善沟通和有效的跨专业协作，并且需要额外的资源。虚拟和面对面相结合的姑息治疗提供模式可能为未来的社区姑息治疗提供最佳解决方案。
