Zhao Yuanyuan, Tu Yuehua, Chew Boon How, Gacasan Eva Marie
The School of Smart Health and Wellness (Health Medical College), Zhejiang Dongfang Polytechnic, China, Wunzhou, Zhejiang, China
School of International Education, Jiangxi Science and Technology Normal University, China, Nanchang, Jiangxi, China.
BMJ Open. 2024 Dec 20;14(12):e083018. doi: 10.1136/bmjopen-2023-083018.
End-of-life care is essential for older adults aged ≥60, particularly those residing in long-term care facilities, such as nursing homes, which are known for their home-like environments compared with hospitals. Due to potential limitations in medical resources, collaboration with external healthcare providers is crucial to ensure comprehensive services within these settings. Previous studies have primarily focused on team-based models for end-of-life care in hospitals and home-based settings. However, there is a lack of sufficient evidence on practices in such facilities, particularly for Chinese older adults. The aim of this scoping review is to map the existing literature and inform the development of an appropriate care framework for end-of-life care in nursing homes. The focus of this article will be on the scope of services, guidelines for decision making, roles within interdisciplinary teams, and the practical feasibility of care provision.
A systematic search will be conducted across nine electronic databases: PubMed, Scopus, EMBASE, Cochrane, PsycINFO, ERIC, CINAHL, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The search will identify literature published in English and Chinese from January 2012 onwards. Articles will be selected based on their relevance to older adults aged ≥60 with disabilities or life-threatening chronic conditions receiving end-of-life care in nursing homes or similar settings. The data extraction process will be guided by the Canadian Hospice Palliative Care Association model (CHPCA) and the Respectful Death model. Qualitative data analysis will be performed using a framework method and thematic analysis, employing both inductive and deductive approaches, with three reviewers participating in the review process.
Ethical approval is not required because the data for this review is obtained from selected publicly available articles. The results will be disseminated through publications in peer-reviewed journals and presented at relevant conferences. Furthermore, the findings will be shared with policymakers and healthcare professionals engaged in end-of-life care to inform practice and decision making.
The review protocol has been registered on osf.io (https://osf.io/3u4mp).
临终关怀对于60岁及以上的老年人至关重要,尤其是那些居住在长期护理机构中的老人,如养老院,与医院相比,养老院以其类似家庭的环境而闻名。由于医疗资源可能存在限制,与外部医疗服务提供者合作对于确保这些机构内的全面服务至关重要。先前的研究主要集中在医院和家庭环境中的临终关怀团队模式。然而,对于此类机构中的实践,特别是针对中国老年人的实践,缺乏足够的证据。本范围综述的目的是梳理现有文献,并为制定养老院临终关怀的适当护理框架提供信息。本文的重点将放在服务范围、决策指南、跨学科团队中的角色以及护理提供的实际可行性上。
将在九个电子数据库中进行系统检索:PubMed、Scopus、EMBASE、Cochrane、PsycINFO、ERIC、CINAHL、中国知网(CNKI)和万方数据。检索将识别2012年1月起以英文和中文发表的文献。文章将根据其与在养老院或类似环境中接受临终关怀的60岁及以上残疾或患有危及生命的慢性病的老年人的相关性进行选择。数据提取过程将以加拿大临终关怀与姑息治疗协会模型(CHPCA)和尊严死亡模型为指导。将使用框架法和主题分析法进行定性数据分析,采用归纳法和演绎法,由三位评审员参与评审过程。
由于本综述的数据来自选定的公开可用文章,因此无需伦理批准。结果将通过在同行评审期刊上发表以及在相关会议上展示进行传播。此外,研究结果将与从事临终关怀的政策制定者和医疗专业人员分享,以为实践和决策提供信息。
该综述方案已在osf.io(https://osf.io/3u4mp)上注册。