Kokorelias Kristina M, Eaton Andrew D, Wasilewski Marina, Redublo Tyler, Sirisegaram Luxey
Section of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Toronto, Ontario, Canada.
Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2024 Dec 2;19(12):e0313879. doi: 10.1371/journal.pone.0313879. eCollection 2024.
End-of-life care supports individuals in the last few weeks or months of their life and their caregivers, offering psychosocial support, symptom management and relief, and resources. While some of the first public end-of-life care facilities were established due to HIV/AIDS, the current needs of caregivers for people living with end-stage HIV are not well understood. Caregivers provide two-thirds of the care for people living with HIV, yet their specific support needs and experiences are under-researched. Existing strategies often use a "one-size-fits-all" approach, which may not address the unique challenges faced by these caregivers, such as stigma and lack of social support. This study aims to synthesize the literature on the end-of-life care experiences and needs of caregivers for individuals living with HIV.
A scoping review, guided by Arksey and O'Malley's framework and the Joanna Briggs Institute's recommendations, will be conducted. An Information Specialist will assist in developing a search strategy to be applied across databases like Medline, Embase, PsycINFO, and PubMed. Search results from each database will be imported into Covidence software for duplicate removal and title and abstract screening. Two researchers will independently screen studies using the 'Population-Concept-Context' (PCC) framework, with screening conducted at two levels: title and abstract, and full-text. The inclusion criteria will be piloted on a random sample of articles to ensure inter-rater agreement (kappa statistic >0.61). Disagreements will be resolved through discussion or with the involvement of a content expert if needed. Final selections will be reported using the PRISMA flow diagram, and reasons for exclusion will be documented.
The findings from this scoping review will provide valuable insights into the end-of-life care experiences and support needs of caregivers for individuals living with HIV. By identifying common themes and challenges, such as caregiver fatigue, emotional strain, stigma, and lack of social support, this study will underscore the inadequacy of the current "one-size-fits-all" approach in addressing the unique needs of these caregivers. This research has the potential to influence both clinical practice and policy by advocating for more personalized support strategies within end-of-life care settings.
临终关怀为处于生命最后几周或几个月的个人及其照料者提供支持,包括心理社会支持、症状管理与缓解以及资源。虽然一些首批公共临终关怀设施是因艾滋病毒/艾滋病而设立的,但目前对于晚期艾滋病毒感染者照料者的需求了解不足。照料者为艾滋病毒感染者提供了三分之二的护理,但他们具体的支持需求和经历却研究不足。现有策略通常采用“一刀切”的方法,可能无法应对这些照料者所面临的独特挑战,如耻辱感和缺乏社会支持。本研究旨在综合关于艾滋病毒感染者照料者临终关怀经历和需求的文献。
将按照阿克西和奥马利的框架以及乔安娜·布里格斯研究所的建议进行一项范围综述。一名信息专家将协助制定搜索策略,以应用于诸如医学索引数据库(Medline)、荷兰医学文摘数据库(Embase)、心理学文摘数据库(PsycINFO)和医学期刊数据库(PubMed)等数据库。每个数据库的搜索结果将导入Covidence软件进行重复项去除以及标题和摘要筛选。两名研究人员将使用“人群 - 概念 - 背景”(PCC)框架独立筛选研究,筛选分两个层面进行:标题和摘要以及全文。纳入标准将在随机抽取的文章样本上进行预试验,以确保评分者间的一致性(kappa统计量>0.61)。如有分歧,将通过讨论解决,必要时可请内容专家参与。最终选择结果将使用系统评价和Meta分析的首选报告项目(PRISMA)流程图进行报告,并记录排除原因。
本次范围综述的结果将为艾滋病毒感染者照料者的临终关怀经历和支持需求提供有价值的见解。通过识别诸如照料者疲劳、情感压力、耻辱感和缺乏社会支持等共同主题和挑战,本研究将凸显当前“一刀切”方法在满足这些照料者独特需求方面的不足。这项研究有可能通过倡导在临终关怀环境中采用更个性化的支持策略来影响临床实践和政策。