Alshakhs Sulaiman, Park Taeyoung, McDarby Meghan, Reid M Cary, Czaja Sara, Adelman Ronald, Sweet Elisabeth, Jedlicka Caroline M, Delgado Diana, Phongtankuel Veerawat
Weill Cornell Medicine, Doha, Qatar.
Weill Cornell Medicine, New York, New York, USA.
J Palliat Med. 2024 Jan;27(1):112-127. doi: 10.1089/jpm.2023.0160. Epub 2023 Aug 11.
There is a need for understanding the breadth of interventions for caregivers of individuals receiving hospice care at home, given the important role caregivers play in caring and the negative outcomes (e.g., depression) associated with their caregiving. Previous reviews were limited in scope to certain types of interventions or patient populations. The objective of this scoping review was to broadly examine the interventions targeting caregivers who provide care to terminally ill patients in home, with the purpose of (1) describing the characteristics of these interventions, (2) discussing key outcomes, limitations, and knowledge gaps, (3) highlighting intervention strengths, and (4) proposing future research directions. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Intervention studies that met the inclusion criteria and that were published up until October 2022 were obtained from the following databases: Ovid MEDLINE, Ovid EMBASE, CINAHL (EBSCO), and The Cochrane Library (Wiley). We analyzed 76 studies describing 55 unique interventions that took place in 14 countries. Interventions were largely delivered by nurses ( = 18, 24%), followed by an interdisciplinary team ( = 16, 21%), a health care provider ( = 10, 13%), research staff ( = 10, 13%), social worker ( = 5, 7%), and others ( = 11, 15%). Six interventions (8%) were self-administered. The most measured outcome was caregiver quality of life ( = 20, 26%), followed by anxiety ( = 18, 24%) and burden ( = 15, 20%). Missing data on patient and caregiver characteristics (i.e., age, gender) were common, and less than half of studies ( = 32, 42%) reported race/ethnicity data. Our review highlighted the current state of interventions for caregivers of patients receiving hospice care at home. Many of the interventions were in the early phases of development, raising the need for future studies to look at efficacy, effectiveness, and the ability to implement interventions in real-world settings.
鉴于家庭临终关怀患者的照护者在护理中发挥的重要作用以及与照护相关的负面结果（如抑郁），有必要了解针对家庭临终关怀患者照护者的干预措施的广度。以往的综述在范围上局限于某些类型的干预措施或患者群体。本范围综述的目的是广泛考察针对在家中为绝症患者提供照护的照护者的干预措施，目的是：（1）描述这些干预措施的特征；（2）讨论关键结果、局限性和知识空白；（3）突出干预措施的优势；（4）提出未来的研究方向。我们遵循系统评价和Meta分析扩展版的范围综述首选报告项目（PRISMA-ScR）。符合纳入标准且截至2022年10月发表的干预研究从以下数据库中获取：Ovid MEDLINE、Ovid EMBASE、CINAHL（EBSCO）和Cochrane图书馆（Wiley）。我们分析了76项研究，这些研究描述了在14个国家开展的55种独特干预措施。干预措施主要由护士提供（n = 18，24%），其次是跨学科团队（n = 16，21%）、医疗保健提供者（n = 10，13%）、研究人员（n = 10，13%）、社会工作者（n = 5，7%）以及其他人员（n = 11，15%）。六项干预措施（8%）是自我实施的。最常测量的结果是照护者的生活质量（n = 20，26%），其次是焦虑（n = 18，24%）和负担（n = 15，20%）。患者和照护者特征（即年龄、性别）的缺失数据很常见，不到一半的研究（n = 32，42%）报告了种族/族裔数据。我们的综述突出了针对家庭临终关怀患者照护者的干预措施的现状。许多干预措施尚处于早期开发阶段，这就需要未来的研究考察其有效性、效果以及在现实环境中实施干预措施的能力。
