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居家姑息治疗的促进因素和障碍的元聚合

Meta-aggregation of facilitators and barriers to home-based palliative care.

作者信息

Liu Zixuan, Zhang Hui, Zhang Yuxuan, Dai Yuqing, Sheng Yu

机构信息

School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100043, China.

出版信息

BMC Palliat Care. 2025 May 22;24(1):146. doi: 10.1186/s12904-025-01788-1.

Abstract

BACKGROUND

Home-based palliative care is in the early stages of development, and its implementation continues to face numerous challenges.

OBJECTIVE

This study aims to systematically synthesize qualitative research on the facilitators and barriers to home-based palliative care, offering evidence-based recommendations to support the advancement of palliative care in China.

METHODS

A systematic search was conducted across multiple databases including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, Wanfang,2222 and VIP Database for qualitative studies related to home-based palliative care, with the search covering studies published up to October 3, 2024. Quality assessment was performed using the JBI standards for qualitative research. Meta-Aggregation was performed using an aggregative integration approach, and the data were analyzed and managed using Nvivo software.

CONCLUSIONS

Twelve studies involving 334 participants were included. Ninety-nine initial findings were extracted and categorized into eight groups. Facilitators included family support, collaboration within interdisciplinary teams, and community resource availability. Barriers comprised challenges in healthcare policies, cultural and social influences, lack of Knowledge and Attitudes of Healthcare Workers, lack of Knowledge and Attitudes of Patients and Families, and insufficient home care resources.

CONCLUSION

To advance palliative care in China, it is critical to enhance policy support and financial backing, improve the education and training of healthcare professionals and the public in diverse cultural settings, strengthen community nursing capabilities, and explore the integration of information technology in care delivery.

摘要

背景

居家姑息治疗正处于发展初期,其实施仍面临诸多挑战。

目的

本研究旨在系统整合关于居家姑息治疗促进因素和障碍的定性研究,提供基于证据的建议,以支持中国姑息治疗的发展。

方法

在多个数据库中进行系统检索,包括PubMed、Web of Science、Embase、Cochrane图书馆、CINAHL、中国知网、万方和维普数据库,检索与居家姑息治疗相关的定性研究,检索涵盖截至2024年10月3日发表的研究。使用JBI定性研究标准进行质量评估。采用综合整合方法进行元聚合,并使用Nvivo软件对数据进行分析和管理。

结论

纳入12项研究,涉及334名参与者。提取99项初始研究结果并分为八组。促进因素包括家庭支持、跨学科团队内部协作和社区资源可用性。障碍包括医疗政策挑战、文化和社会影响、医护人员知识和态度不足、患者及家属知识和态度不足以及居家护理资源不足。

结论

为推进中国的姑息治疗,加强政策支持和资金支持、改善不同文化背景下医护人员和公众的教育与培训、增强社区护理能力以及探索信息技术在护理服务中的整合至关重要。

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