Demuro Mauro, Bratzu Elisa, Lorrai Stefano, Preti Antonio
Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Clin Pract Epidemiol Ment Health. 2024 Mar 5;20(Suppl-1):e17450179183857. doi: 10.2174/0117450179183857240226094258. eCollection 2024.
The area of palliative care is a setting in which the evaluation of the quality of life (QoL) is fundamental. However, the topic has been covered from many different points of view, and there is a lack of comprehensive synthesis of the evidence drawn from the available literature.
We carried out a meta-review of all available systematic reviews and meta-analyses that have dedicated part or most of the investigation to the assessment of QoL in palliative care to provide the most updated and comprehensive depiction of all available information about measurement and intervention aimed at improving QoL in palliative care.
A meta-review of all recent (5 years) available systematic reviews and meta-analyses on "palliative care" and "quality of life" was carried out. The quality of the extracted studies was assessed with the AMSTAR scale.
The search extracted 24 systematic reviews, 14 systematic reviews followed by a meta-analysis on a subset of data, and 2 meta-analyses. In many studies, the investigation of QoL represented a secondary or even marginal outcome. In general, the results supported the efficacy of palliative care in terminal patients or patients with a permanent disability. However, the quality of the studies had a strong influence on the chance that some improvement in QoL was found in relation to palliative care. Studies of lower quality were more likely to report some efficacy of palliative care than studies with better quality.
The investigation of QoL in palliative care is understudied. In many studies, QoL is a secondary outcome, and there is some tendency to use a disparate range of tools to measure it, whose reliability and validity should still be established in some groups of patients.
姑息治疗领域中，生活质量（QoL）评估至关重要。然而，该主题已从许多不同角度进行了探讨，且缺乏对现有文献证据的全面综合。
我们对所有可用的系统评价和荟萃分析进行了元综述，这些研究将部分或大部分调查致力于姑息治疗中生活质量的评估，以提供关于旨在改善姑息治疗中生活质量的测量和干预的所有可用信息的最新和全面描述。
对所有最近（5年）关于“姑息治疗”和“生活质量”的可用系统评价和荟萃分析进行了元综述。采用AMSTAR量表评估提取研究的质量。
检索到24项系统评价、14项在部分数据上进行荟萃分析的系统评价以及2项荟萃分析。在许多研究中，生活质量调查是次要甚至边缘性结果。总体而言，结果支持姑息治疗对终末期患者或永久性残疾患者的疗效。然而，研究质量对发现姑息治疗与生活质量改善相关的可能性有很大影响。质量较低的研究比质量较好的研究更有可能报告姑息治疗的某些疗效。
姑息治疗中生活质量的研究未得到充分研究。在许多研究中，生活质量是次要结果，并且存在使用各种不同工具进行测量的趋势，在某些患者群体中，这些工具的可靠性和有效性仍有待确定。
