Institute of Public Health, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Department of Palliative Medicine, University Medical Center Göttingen, Georg-August University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
Health Policy. 2024 Dec;150:105174. doi: 10.1016/j.healthpol.2024.105174. Epub 2024 Sep 30.
Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED.
In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021. We included quantitative and qualitative research examining the experiences, attitudes, and knowledge of people confronted with VSED. We inductively analyzed the data after quantitative data transformation. We assessed quality and confidence using the Mixed-Methods Appraisal Tool and GRADE-CERQual approach, respectively. This study was registered in PROSPERO (CRD42022283743).
We identified 22 eligible articles, comprising 16 studies. The participants were healthcare professionals and relatives, but not individuals undertaking VSED. We present here our findings on the challenges of accompanying VSED, positive experiences with VSED, and the identified needs. Support during VSED is needed at multiple levels (medical care, family relief, course planning), and the willingness to accompany VSED is very high among healthcare professionals. However, there are several problems, the most obvious being the lack of knowledge and expertise regarding VSED, placing a great burden on families and professionals. The confidence in the review findings ranged from moderate to low.
Evidence-based guidance, in-depth knowledge, and training of healthcare professionals can greatly reduce the burden and fear among individuals accompanying VSED.
自愿停止进食和饮水（VSED）是一种提前结束生命的方式。我们综合了有关 VSED 的经验数据。
在这项系统的混合方法综述中，我们检索了 MEDLINE、CINAHL、PsycINFO、Google Scholar 和 BELIT，以获取 2013 年 1 月 1 日至 2021 年 11 月 12 日期间发表的英文和德文文章。我们纳入了研究人们面临 VSED 时的经历、态度和知识的定量和定性研究。在进行定量数据分析后，我们进行了归纳分析。我们分别使用混合方法评估工具和 GRADE-CERQual 方法评估质量和信心。本研究已在 PROSPERO（CRD42022283743）上注册。
我们确定了 22 篇符合条件的文章，其中包括 16 项研究。参与者是医疗保健专业人员和亲属，但不是正在进行 VSED 的个人。我们在此介绍我们在伴随 VSED 的挑战、对 VSED 的积极体验以及确定的需求方面的发现。在多个层面上都需要在 VSED 期间提供支持（医疗护理、家庭缓解、课程规划），医疗保健专业人员非常愿意伴随 VSED。然而，存在一些问题，最明显的是缺乏有关 VSED 的知识和专业知识，这给家庭和专业人员带来了很大的负担。对综述结果的信心从中等到低不等。
为医疗保健专业人员提供循证指导、深入的知识和培训，可以大大减轻伴随 VSED 的个人的负担和恐惧。
