Austin Philip D, Lee Wei, Keall Robyn, Lovell Melanie R
Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, NSW, Australia.
Improving Care for Palliative Aged, and Chronic Care Through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Palliat Med. 2025 Jan;39(1):70-85. doi: 10.1177/02692163241287650. Epub 2024 Oct 16.
Spiritual care is increasingly recognised as an essential component of care in palliative settings. Given this growing body of literature on spiritual interventions, there is a need to systematically evaluate and synthesis findings from previous systematic reviews.
To systematically synthesise the available evidence from systematic reviews concerning (a) the efficacy of spiritual care interventions and (b) the extent and nature of spiritual care interventions used in specialist palliative care settings.
An umbrella review of systematic reviews was conducted in accordance with PROSPERO (CRD42024455147) and followed the Joanna Briggs Institute methodology for umbrella reviews.
Electronic databases (Ovid Medline, Embase, APA PsycINFO, Cochrane Database of Systematic Reviews, CINAHL and Web of Science) and references of accepted systematic reviews were searched for systematic reviews from inception to 2024. The AMSTAR-2 criteria was used to assess risk of bias within systematic reviews.
A toal of 27 reviews met the eligibility criteria and reported the effects of 14 different spiritual care interventions across 431 studies including 55,759 participants. Findings show that spiritual care interventions especially dignity therapy and life-review may be effective for improving outcomes including spiritual wellbeing, emotional symptoms, quality-of-life and physical symptoms in people receiving specialist palliative care. Under half of included reviews report follow-up data where only emotional symptoms and quality-of-life are reported at more than one time-point.
Overall, spiritual care interventions have positive effects on spiritual wellbeing, quality of life and mood, compared to control conditions. Increased methodological rigour is needed to capture effect and duration of effect with spiritual care interventions at different phases of palliative care.
在姑息治疗环境中，精神关怀日益被视为护理的重要组成部分。鉴于关于精神干预的文献不断增加，有必要系统地评估和综合以往系统评价的结果。
系统地综合系统评价中的现有证据，内容涉及（a）精神关怀干预的效果，以及（b）专科姑息治疗环境中使用的精神关怀干预的范围和性质。
根据PROSPERO（CRD42024455147）进行系统评价的伞状评价，并遵循乔安娜·布里格斯研究所的伞状评价方法。
检索电子数据库（Ovid Medline、Embase、APA PsycINFO、Cochrane系统评价数据库、CINAHL和科学网）以及已接受的系统评价的参考文献，以查找从创刊到2024年的系统评价。使用AMSTAR-2标准评估系统评价中的偏倚风险。
共有27项评价符合纳入标准，报告了14种不同精神关怀干预在431项研究中的效果，涉及55759名参与者。研究结果表明，精神关怀干预，尤其是尊严疗法和生活回顾，可能对改善接受专科姑息治疗的患者的精神健康、情绪症状、生活质量和身体症状等结局有效。纳入的评价中不到一半报告了随访数据，其中只有情绪症状和生活质量在多个时间点进行了报告。
总体而言，与对照条件相比，精神关怀干预对精神健康、生活质量和情绪有积极影响。需要提高方法的严谨性，以了解姑息治疗不同阶段精神关怀干预的效果和效果持续时间。
