Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
BMC Geriatr. 2024 Aug 24;24(1):700. doi: 10.1186/s12877-024-05259-9.
Innovative small-scale facilities for dementia focus on providing quality of life and maintaining the functional abilities of residents while offering residents a home for life. To fulfill the home-for-life principle, palliative care approaches are necessary to maintain quality of life in these facilities. Few studies have reported on how palliative care is provided to residents in small-scale facilities. The aim of our review is to determine the extent to which palliative care approaches are reported in small-scale facilities.
A scoping review of the literature using recommended methods from the Joanna Briggs Institute. Four databases, CINAHL, PubMed, PsycINFO, and Web of Science, were searched for studies published from 1995 to 2023. One reviewer completed the title, abstract and full-text screening and data extraction; two additional team members piloted the screening and extraction process and met with the main reviewer to make decisions about article inclusion and ensure consistency and accuracy in the review process. The extracted data was open-coded and analyzed using thematic analysis. The data was then synthesized into themes using palliative care domains for dementia.
Of the 800 articles obtained in the search, only ten met the inclusion criteria: six from Japan, two from the Netherlands, and one each from Austria and the United States. In most small-scale facilities, palliative care is important, with facilities prioritizing family involvement and person-centred care, minimizing resident discomfort and enhancing residents' remaining abilities until the end of life. The included studies did not discuss palliative care policies or professional staff training in depth.
This study provides an overview of the literature on palliative care in small-scale facilities for individuals with dementia. Most facilities focus on residents' wishes at the end of life to enhance comfort and provide a home-like environment. However, more research is needed to further understand the quality of palliative care approaches in these homes.
创新的小规模痴呆症护理设施注重提供生活质量并维持居民的功能能力，同时为居民提供终身的家。为了实现终身居住的原则，这些设施需要姑息治疗方法来维持生活质量。很少有研究报告过小规模设施中如何为居民提供姑息治疗。我们的综述旨在确定在小规模设施中报告姑息治疗方法的程度。
使用 Joanna Briggs 研究所推荐的方法进行文献范围综述。四个数据库，CINAHL、PubMed、PsycINFO 和 Web of Science，被搜索了从 1995 年到 2023 年发表的研究。一位评审员完成了标题、摘要和全文筛选和数据提取；另外两位团队成员试用了筛选和提取过程，并与主要评审员会面，就文章纳入标准做出决定，并确保审查过程的一致性和准确性。提取的数据采用主题分析进行开放编码和分析。然后使用痴呆症姑息治疗领域将数据综合成主题。
在搜索中获得的 800 篇文章中，只有 10 篇符合纳入标准：6 篇来自日本，2 篇来自荷兰，1 篇分别来自奥地利和美国。在大多数小规模设施中，姑息治疗很重要，设施优先考虑家庭参与和以患者为中心的护理，最大限度地减少居民的不适，并增强居民的剩余能力，直到生命结束。纳入的研究没有深入讨论姑息治疗政策或专业人员的培训。
本研究提供了对小规模痴呆症护理设施中姑息治疗文献的概述。大多数设施都关注居民在生命末期的愿望，以提高舒适度并提供类似家庭的环境。然而，需要进一步研究以更深入地了解这些家庭中姑息治疗方法的质量。
