Yin Guo, Macaden Leah, Sivaramakrishnan Divya, Wang Yajing, Zhu Lian, Chong Huimin
Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
Dementia (London). 2025 May;24(4):794-831. doi: 10.1177/14713012241308625. Epub 2024 Dec 15.
Integrating home-based end-of-life care for people with dementia will become increasingly important as the population ages. Therefore, it is timely and necessary to evaluate the evidence of home-based end-of-life care for people living with dementia. This review aims to identify the characteristics of home-based end-of-life care interventions for people living with dementia and review the existing evidence on implementation outcomes. Systematic Review and Narrative Synthesis. The Mixed Methods Appraisal Tool was used to assess study quality. A comprehensive search was conducted across five databases (PubMed, Web of Science, MEDLINE CINAHL and Scopus) from June to August 2023, and the citations to the included studies were tracked through citation tracking in Google Scholar to identify potentially relevant studies. Of the 2022 articles retrieved, 12 were included in this review. The included studies were geographically diverse, with four from the United States, three from Singapore, two from the United Kingdom, and one each from the Netherlands, Belgium, and Israel. Additionally, due to the difference of focus and nature of the studies, only seven of these studies provided information on home-based end-of-life care interventions for people living with dementia. The interventions identified in this review align closely with the essential components of optimal palliative care for dementia outlined in the European Association for Palliative Care white paper. However, the evidence supporting these home-based end-of-life care interventions for people living with dementia is constrained by the number of studies and methodological limitations. Nevertheless, this systematic review still identifies some evidence supporting home-based end-of-life care for people living with dementia, including reduced healthcare utilization and costs, as well as help people living with dementia realize their wish to die at home. Whilst current evidence highlights benefits of home-based end-of-life care for people living with dementia, the relatively limited number, methodology of studies, the heterogeneity of study focus and outcome measures hinder the formation of definitive conclusions. Therefore, further research is needed to develop and evaluate home end-of-life care services for people living with dementia.
随着人口老龄化，为痴呆症患者提供居家临终关怀将变得越来越重要。因此，评估针对痴呆症患者的居家临终关怀证据既及时又必要。本综述旨在确定针对痴呆症患者的居家临终关怀干预措施的特点，并回顾有关实施效果的现有证据。系统评价和叙述性综合分析。使用混合方法评估工具来评估研究质量。2023年6月至8月，在五个数据库（PubMed、科学网、MEDLINE、CINAHL和Scopus）中进行了全面检索，并通过谷歌学术的引文跟踪对纳入研究的引文进行跟踪，以识别潜在的相关研究。在检索到的2022篇文章中，有12篇纳入了本综述。纳入的研究在地理上分布广泛，其中4篇来自美国，3篇来自新加坡，2篇来自英国，1篇分别来自荷兰、比利时和以色列。此外，由于研究重点和性质的差异，这些研究中只有7篇提供了针对痴呆症患者的居家临终关怀干预措施的信息。本综述中确定的干预措施与欧洲姑息治疗协会白皮书概述的痴呆症最佳姑息治疗的基本组成部分密切相关。然而，支持这些针对痴呆症患者的居家临终关怀干预措施的证据受到研究数量和方法学局限性的限制。尽管如此，本系统评价仍确定了一些支持针对痴呆症患者的居家临终关怀的证据，包括减少医疗保健利用和成本，以及帮助痴呆症患者实现在家中去世的愿望。虽然目前的证据突出了居家临终关怀对痴呆症患者的益处，但研究数量相对有限、研究方法、研究重点的异质性和结果测量方法阻碍了确定性结论的形成。因此，需要进一步研究来开发和评估针对痴呆症患者的居家临终关怀服务。
