预先护理计划对决策冲突和心理困扰的影响：随机对照试验的系统评价和荟萃分析
The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
作者信息
Yeun Young-Ran
机构信息
Department of Nursing, Kangwon National University, Samcheok, Korea.
出版信息
J Hosp Palliat Care. 2021 Sep 1;24(3):144-153. doi: 10.14475/jhpc.2021.24.3.144.
PURPOSE
Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress.
METHODS
A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models.
RESULTS
Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI -0.83 to -0.23), depression (d=-1.22; 95% CI -1.71 to -0.74) and anxiety (d=-0.76; 95% CI -1.12 to -0.39).
CONCLUSION
ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.
目的
预先护理计划（ACP）被广泛认为可改善临终护理。本系统评价和荟萃分析旨在研究ACP干预对决策冲突和心理困扰的影响。
方法
2020年11月对PubMed、CINAHL、CENTRAL、EMBASE、KISS、KoreaMed和RISS进行了检索。该研究纳入了随机对照试验。数据使用固定效应模型和随机效应模型进行汇总。
结果
共确定了14项研究，累计纳入1548名参与者。ACP干预在缓解决策冲突（d=-0.53；95%置信区间-0.83至-0.23）、抑郁（d=-1.22；95%置信区间-1.71至-0.74）和焦虑（d=-0.76；95%置信区间-1.12至-0.39）方面有效。
结论
ACP干预对减少决策冲突和心理困扰具有显著的积极影响。在分配隐藏和盲法方面显示出较高的偏倚水平。本研究结果有望为临终护理提供者提高ACP干预的有效性提供帮助。
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