Wang Guiyun, Xiao Jinnan, Chen Zhihan, Huang Chongmei, Deng Yinghua, Tang Siyuan
School of Nursing, Shandong Xiehe University, Jinan, Shandong, China.
Xiangya School of Nursing, Central South University, Changsha, Hunan, China
BMJ Support Palliat Care. 2023 Jun 23. doi: 10.1136/spcare-2022-004146.
An in-depth understanding of what constitutes a good death among patients with cancer is vital to providing patient-centred palliative care. This review aimed to synthesise evidence on the perceptions of a good death among patients with cancer.
This systematic review involved a synthesis of qualitative data. A three-step process suggested by the Joanna Briggs Institute was used to synthesise the data.
A total of 1432 records were identified, and five articles met the inclusion criteria. Seven synthesised findings emerged: (1) being aware of cancer, (2) pain and symptom management, (3) dying well, (4) being remembered after death, (5) individual perspectives of a good death, (6) individual behaviours leading to a good death, and (7) culture and religions. A structural framework was developed to elicit two layers that could be regarded as determinants of a good death. One layer suggested how multiple external issues impact a good death, whereas the other layer involves patients' internal attributes that shape their experiences of a good death. The elements in the two layers were inter-related to exert a crossover effect on good death in specific cultural and religious contexts.
A good death is a process initiated from the time of awareness of cancer and extends beyond demise. Holistic approaches encompassing the management of physical and psychological distress along with psychosocial behavioural interventions to enhance patients' positive perspectives and behaviours are recommended to improve their quality of life and death.
深入了解癌症患者心目中的善终对于提供以患者为中心的姑息治疗至关重要。本综述旨在综合关于癌症患者对善终看法的证据。
本系统综述涉及定性数据的综合分析。采用乔安娜·布里格斯研究所建议的三步法来综合数据。
共识别出1432条记录，5篇文章符合纳入标准。得出了7个综合研究结果：（1）知晓癌症，（2）疼痛和症状管理，（3）善终，（4）身后被铭记，（5）善终的个人观点，（6）导致善终的个人行为，以及（7）文化和宗教。构建了一个结构框架，得出可被视为善终决定因素的两个层面。一个层面表明多个外部问题如何影响善终，而另一个层面涉及塑造患者善终体验的内在属性。这两个层面的要素相互关联，在特定文化和宗教背景下对善终产生交叉影响。
善终是一个从知晓癌症时开始并延伸至死亡之后的过程。建议采用综合方法，包括管理身体和心理痛苦以及进行社会心理行为干预，以增强患者的积极观点和行为，从而改善他们的生活质量和死亡质量。
