School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, Hung Hom, China.
Palliat Med. 2024 Apr;38(4):423-446. doi: 10.1177/02692163241238900.
People with life-threatening diseases and their family caregivers confront psychosocial and spiritual issues caused by the persons' impending death. Reviews of death education interventions in the context of life-threatening diseases are scarce and limited to certain intervention types.
This study aims to ascertain existing evidence on death education interventions for the population of adults with advanced diseases and/or their family caregivers and identify gaps for future research.
A scoping review guided by Arksey and O'Malley's framework.
Thirteen electronic databases were searched for experimental and qualitative studies on death education interventions for the advanced disease population and/or their family caregivers between 1 January 1960 and 25 October 2023.
Nine types of interventions were identified in 47 studies, which included 5 qualitative and 42 experimental designs, half of which were pilot and feasibility trials. Most of the studies focused on people with advanced cancer, and only seven investigated caregivers or families/couples. Death-related outcomes were less likely to be assessed relative to psychological outcomes, spiritual well-being, and quality of life. Life review interventions, cognitive-behavior therapy, narrative therapy, and general psychosocial interventions decreased depression and anxiety, but evidence was limited. Factors contributing to the interventions' success included intervention content, which enabled the disclosure of personal experience and death concerns comfortably, trained professionals, and connection to family caregivers.
This work identified a few potentially effective death education interventions for psychological outcomes for people with advanced cancer or their caregivers. Additional trials are needed to confirm the effectiveness of these interventions.
患有危及生命疾病的患者及其家属照顾者面临着由患者即将死亡引起的心理社会和精神问题。对危及生命疾病背景下的死亡教育干预措施的审查很少,且仅限于某些干预类型。
本研究旨在确定针对晚期疾病患者及其家属照顾者的死亡教育干预措施的现有证据,并确定未来研究的空白。
受 Arksey 和 O'Malley 框架指导的范围综述。
从 1960 年 1 月 1 日至 2023 年 10 月 25 日,13 个电子数据库对针对晚期疾病人群及其家属照顾者的死亡教育干预措施的实验和定性研究进行了检索。
在 47 项研究中确定了 9 种干预措施,其中包括 5 项定性研究和 42 项实验设计,其中一半为试点和可行性试验。大多数研究都集中在晚期癌症患者身上,只有 7 项研究涉及照顾者或家庭/夫妻。与心理结果、精神幸福感和生活质量相比,死亡相关结果的评估可能性较小。生命回顾干预、认知行为疗法、叙事疗法和一般心理社会干预措施降低了抑郁和焦虑,但证据有限。干预措施成功的因素包括干预内容,该内容使个人经验和死亡担忧能够舒适地披露、专业人员的培训以及与家属照顾者的联系。
这项工作确定了一些针对晚期癌症患者或其照顾者的心理结果的潜在有效死亡教育干预措施。需要更多的试验来证实这些干预措施的有效性。