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对参与医疗辅助自杀的个体的家庭成员的丧亲结果的风险和保护因素进行检查和提出理论模型:系统评价。

An examination and proposed theoretical model of risk and protective factors for bereavement outcomes for family members of individuals who engaged in medical aid in dying: A systematic review.

机构信息

Department of Psychological Science, Texas Tech University, Lubbock, TX, USA.

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

出版信息

Palliat Med. 2023 Jul;37(7):947-958. doi: 10.1177/02692163231172242. Epub 2023 May 2.

Abstract

BACKGROUND

Medical Aid in Dying is an end-of-life option that allows a physician to provide a patient with a prescription to end their life. Though Medical Aid in Dying intends to reduce suffering for a patient, opponents argue Medical Aid in Dying may increase suffering for the family members during bereavement. To better understand the bereavement outcomes for family members/friends following Medical Aid in Dying, an exhaustive review of the risk and protective factors for bereavement outcomes is warranted.

AIM

This systemic review aimed to identify studies that examined bereavement outcomes of family members of individuals who engage in Medial Aid in Dying, identify risk and protective factors for bereavement outcomes, and propose a theoretical model to enhance conceptual clarity.

DESIGN

A mixed-method systematic review.

DATA SOURCES

Ten databases were searched on June 16, 2021 and later conducted two updates (latest April 25, 2022).

RESULTS

Thirteen articles met inclusion criteria. Risk and protective factors were identified pre-Medical Aid in Dying and risk factors post-Medical Aid in Dying. Few studies compared bereavement outcomes for family members of individuals utilizing Medical Aid in Dying to family members who lost someone to natural loss.

CONCLUSIONS

This study provides equivocal results about the effects of Medical Aid in Dying on family members following the loss. The theoretical model outlines potential risk and protective factors. This model provides a greater understanding of possible universal risk and protective factors for family members of individuals who engaged in Medical Aid in Dying.

摘要

背景

医疗辅助死亡是一种临终选择,允许医生为患者提供结束生命的处方。尽管医疗辅助死亡旨在减轻患者的痛苦,但反对者认为,医疗辅助死亡可能会增加患者家属在丧亲期间的痛苦。为了更好地了解医疗辅助死亡后家属/朋友的丧亲结果,有必要全面审查丧亲结果的风险和保护因素。

目的

本系统评价旨在确定研究个体参与医疗辅助死亡后家属的丧亲结果,确定丧亲结果的风险和保护因素,并提出一个理论模型以增强概念清晰度。

设计

混合方法系统评价。

数据来源

2021 年 6 月 16 日在 10 个数据库中进行检索,并于 2022 年 4 月 25 日进行了两次更新。

结果

符合纳入标准的文章有 13 篇。在医疗辅助死亡前确定了风险和保护因素,在医疗辅助死亡后确定了风险因素。很少有研究将利用医疗辅助死亡的个体的家属的丧亲结果与自然死亡的家属的丧亲结果进行比较。

结论

本研究对医疗辅助死亡后家属的影响提供了不确定的结果。理论模型概述了潜在的风险和保护因素。该模型更深入地了解了可能对参与医疗辅助死亡的个体的家属普遍存在的风险和保护因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1208/10320704/e891aa66fc37/10.1177_02692163231172242-fig1.jpg

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