Layne Diana, Logan Ayaba, Lindell Kathleen
College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA.
Academic Affairs, Medical University of South Carolina, Charleston, SC 29425, USA.
Nurs Rep. 2024 Jul 17;14(3):1750-1768. doi: 10.3390/nursrep14030130.
Alzheimer's disease is a serious illness with a protracted caregiving experience; however, care coordination interventions often lack the inclusion of palliative care. The purpose of this integrative review is to identify and synthesize existing care coordination interventions that include palliative care for individuals with dementia and their caregivers living in community settings. The Whittemore and Knafl framework guided the review, with data analysis guided by the SELFIE framework domains. Study quality was assessed using the Mixed Methods Appraisal Tool, while the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines informed reporting results. Nine care coordination interventions involving family caregivers across eighteen publications were identified. Only a single intervention explicitly mentioned palliative care, while the remaining interventions included traditional palliative care components such as advance care planning, symptom management, and emotional support. Many of the identified interventions lacked theoretical grounding and were studied in non-representative, homogeneous samples. Further research is needed to understand the lived experiences of people with dementia and their caregivers to alleviate care coordination burden.
阿尔茨海默病是一种伴有长期照护经历的严重疾病;然而,照护协调干预措施往往缺乏姑息治疗的内容。本整合性综述的目的是识别并综合现有的照护协调干预措施,这些措施包括为居住在社区环境中的痴呆症患者及其照护者提供姑息治疗。惠特莫尔和克纳夫框架指导了本次综述,数据分析则以SELFIE框架领域为指导。使用混合方法评估工具评估研究质量,而系统评价和荟萃分析的首选报告项目(PRISMA)指南为报告结果提供了依据。确定了涉及18篇出版物中的家庭照护者的9种照护协调干预措施。只有一项干预措施明确提及了姑息治疗,而其余干预措施包括诸如预先护理计划、症状管理和情感支持等传统姑息治疗组成部分。许多已确定的干预措施缺乏理论基础,且是在不具代表性的同质化样本中进行研究的。需要进一步开展研究,以了解痴呆症患者及其照护者的生活经历,从而减轻照护协调负担。