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患者和家属对远程姑息治疗的看法:系统综合评价。

Patient and families' perspectives on telepalliative care: A systematic integrative review.

机构信息

Institute of Regional Health Research, Hospital Soenderjylland, University of Southern Denmark, Odense, Denmark.

Department of Internal Medicine, Medical Research Unit, Hospital Soenderjylland, University Hospital of Southern Jutland, Aabenraa, Denmark.

出版信息

Palliat Med. 2024 Jan;38(1):42-56. doi: 10.1177/02692163231217146. Epub 2023 Dec 19.

Abstract

BACKGROUND

Telepalliative care is increasingly used in palliative care, but has yet to be examined from a patient and family perspective. A synthesis of evidence may provide knowledge on how to plan and provide telepalliative care that caters specifically to patients and families' needs.

OBJECTIVE

To synthesise evidence on patients and families' perspectives on telepalliative care.

DESIGN

A systematic integrative review (PROSPERO #CRD42022301206) reported in accordance with PRISMA 2020 guidelines. Inclusion criteria; primary peer-reviewed studies published 2011-2022, patient and family perspective, >18 years, telepalliative care and English/Danish language. Quality was appraised using the mixed-methods appraisal tool, version 2020. Guided by Toronto and Remington, data were extracted, thematically analysed and synthesised.

DATA SOURCES

MEDLINE, EMBASE, PsycINFO and CINAHL were searched in March 2022 and updated in February 2023.

RESULTS

Forty-four studies were included. Analysis revealed five themes; the effect of the Covid-19 pandemic on telepalliative care, adding value for patients and families, synchronous and asynchronous telepalliative care, the integration of telepalliative care with other services and the tailoring and timing of telepalliative care.

CONCLUSION

Enhanced access to care and convenience, as attributes of telepalliative care, are highly valued. Patients and families have varying needs during the illness trajectory that may be addressed by early integration of telepalliative care based on models of care that are flexible and combine synchronous and asynchronous solutions. Further research should examine telepalliative care in a post-pandemic context, use of models of care and identify meaningful outcome measures from patient and family perspectives for evaluation of telepalliative care.

摘要

背景

远程姑息治疗在姑息治疗中越来越多地被使用,但尚未从患者和家属的角度进行检查。证据综合可能提供关于如何规划和提供专门满足患者和家属需求的远程姑息治疗的知识。

目的

综合患者和家属对远程姑息治疗的看法。

设计

按照 PRISMA 2020 指南进行的系统综合评价(PROSPERO #CRD42022301206)。纳入标准;2011 年至 2022 年发表的主要同行评议研究、患者和家属观点、>18 岁、远程姑息治疗和英语/丹麦语。使用混合方法评估工具(2020 年版)评估质量。在多伦多和雷明顿的指导下,提取数据、进行主题分析和综合。

数据来源

2022 年 3 月在 MEDLINE、EMBASE、PsycINFO 和 CINAHL 进行检索,并于 2023 年 2 月更新。

结果

共纳入 44 项研究。分析揭示了五个主题;Covid-19 大流行对远程姑息治疗的影响、为患者和家属增加价值、同步和异步远程姑息治疗、远程姑息治疗与其他服务的整合以及远程姑息治疗的定制和时机。

结论

远程姑息治疗增强了便利性和获取医疗服务的便利性,这些都是非常有价值的。患者和家属在疾病过程中有不同的需求,可以通过基于灵活的护理模式尽早整合远程姑息治疗来满足这些需求,这些模式结合了同步和异步解决方案。进一步的研究应该在大流行后背景下研究远程姑息治疗,使用护理模式,并从患者和家属的角度确定有意义的结果衡量标准,以评估远程姑息治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/417b/10865769/da75263b56dc/10.1177_02692163231217146-fig1.jpg

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