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在家中离世:哪些因素促进或阻碍了痴呆症患者的居家临终关怀?——一项系统评价和元民族志研究方案

Bring dying at home: What facilitates and hinders home-based end-of-life care for people living with dementia?-A systematic review and meta-ethnography protocol.

作者信息

Yin Guo, Sivaramakrishnan Divya, Macaden Leah

机构信息

Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom.

出版信息

PLoS One. 2024 Dec 30;19(12):e0316446. doi: 10.1371/journal.pone.0316446. eCollection 2024.

Abstract

BACKGROUND

Although home-based end-of-life care is more in line with the preferences of people living with dementia, operationalizing this ideal remains challenging. Many people living with dementia are still unable to die at home or receive end-of-life care at home. This review aims to apply meta-ethnography to synthesize existing qualitative studies, to identify the facilitators and barriers of home-based end-of-life care for people living with dementia.

METHODS

This review will use the meta-ethnography method to systematically synthesize and analyze qualitative studies. The seven stages described by Noblit and Hare (1988) will serve as the framework for this review. The systematic literature search will comprehensively cover the following databases: PubMed, MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL, and Web of Science. Inclusion criteria are: (A) qualitative research design; (B) participants are people living with dementia, family caregivers, or healthcare providers; (C) discussion of barriers and facilitators affecting home end-of-life care for people living with dementia; (D) original peer-reviewed studies in English. The included studies will be quality assessed using the CASP quality assessment form. The entire research process will refer to the meta-ethnography reporting guidelines (eMERGe) and the PRISMA statement to ensure the scientific and systematic nature of the results.

DISCUSSION

This review will synthesize and analyze the results of different qualitative studies, transforming different perspectives through an iterative process of comparison, translation, and synthesis to generate new insights, and will form a comprehensive and insightful interpretive framework. This will promote a more comprehensive and in-depth understanding of the facilitators and barriers to the implementation of home-based end-of-life care for people living with dementia. In addition, the results of this review will guide the development and improvement of home-based end-of-life care interventions for people living with dementia, and guide policymakers and practitioners to optimize relevant policies and services.

摘要

背景

尽管居家临终关怀更符合痴呆症患者的偏好,但将这一理想付诸实践仍具有挑战性。许多痴呆症患者仍无法在家中离世或接受居家临终关怀。本综述旨在运用元民族志方法综合现有定性研究,以确定痴呆症患者居家临终关怀的促进因素和障碍。

方法

本综述将采用元民族志方法系统地综合和分析定性研究。诺布利特和黑尔(1988年)描述的七个阶段将作为本综述的框架。系统的文献检索将全面覆盖以下数据库:PubMed、MEDLINE、EMBASE、考克兰图书馆、PsycINFO、CINAHL和科学网。纳入标准为:(A)定性研究设计;(B)参与者为痴呆症患者、家庭护理人员或医疗服务提供者;(C)讨论影响痴呆症患者居家临终关怀的障碍和促进因素;(D)英文原创的同行评审研究。将使用CASP质量评估表对纳入的研究进行质量评估。整个研究过程将参考元民族志报告指南(eMERGe)和PRISMA声明,以确保结果的科学性和系统性。

讨论

本综述将综合和分析不同定性研究的结果,通过比较、转化和综合的迭代过程转变不同观点以产生新的见解,并将形成一个全面且有见地的解释框架。这将促进对痴呆症患者居家临终关怀实施的促进因素和障碍有更全面和深入的理解。此外,本综述的结果将指导针对痴呆症患者的居家临终关怀干预措施的开发和改进,并指导政策制定者和从业者优化相关政策和服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f78/11684621/04a9b18d1efb/pone.0316446.g001.jpg

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