Patynowska Katarzyna Anna, Hasson Felicity, McConnell Tracey, McIlfatrick Sonja
Institute of Nursing and Health Research, Ulster University, Belfast, UK
Marie Curie Hospice, Belfast, UK.
BMJ Open. 2025 Jun 4;15(6):e095990. doi: 10.1136/bmjopen-2024-095990.
Globally, the demand for community palliative care, delivered within the home setting, is rising. Hospice support workers, also referred to as healthcare assistants, play a crucial role in providing this care, but evidence indicates they face challenges relating to inadequate training, isolation and emotional labour. This realist review aims to understand how peer support interventions can support healthcare assistants in delivering hospice care at home.
The realist review will follow a five-step process to explore the research question: (1) locating existing initial programme theories, (2) searching for evidence, (3) selecting and appraising evidence, (4) extracting and organising data and (5) synthesising evidence and drawing conclusions. Comprehensive searches of academic databases (CINAHL, MEDLINE, AMED, Scopus) and grey literature sources will be conducted between November and December 2024, with no restrictions on publication date applied. Search strategies will be iteratively refined, with evidence selected based on relevance and rigour. Data will be extracted and coded using a realist logic model of analysis. The review will develop an explanatory programme theory for peer-to-peer interventions which would identify what, how, for whom, why and in what circumstances peer-to-peer interventions may support delivery of hospice care at home. It will explore the contexts, mechanisms and outcomes of these interventions using context-mechanism-outcome configurations.
Ethical approval is not required as the review involves no primary data collection. This review aims to clarify research gaps, inform next stages of a wider study, policy and practice. Reporting of the findings will adhere to RAMESES publication standards for realist syntheses, ensuring transparency and rigour in reporting. Results will be disseminated through peer-reviewed publications, conference presentations and other strategies identified by the stakeholder group.
CRD42024606133.
在全球范围内，对居家社区姑息治疗的需求正在上升。临终关怀支持工作者，也被称为医疗保健助理，在提供这种护理方面发挥着关键作用，但有证据表明他们面临着培训不足、孤立无援和情感劳动等挑战。这项现实主义综述旨在了解同伴支持干预措施如何支持医疗保健助理在家中提供临终关怀。
现实主义综述将遵循五个步骤来探讨研究问题：（1）定位现有的初始项目理论，（2）寻找证据，（3）选择和评估证据，（4）提取和整理数据，（5）综合证据并得出结论。将于2024年11月至12月对学术数据库（CINAHL、MEDLINE、AMED、Scopus）和灰色文献来源进行全面检索，不设出版日期限制。检索策略将不断完善，根据相关性和严谨性选择证据。将使用现实主义分析逻辑模型提取和编码数据。该综述将为同伴间干预制定一个解释性项目理论，该理论将确定同伴间干预在何种情况下、如何、针对何人、为何以及在何种情况下可能支持在家中提供临终关怀。它将使用背景-机制-结果配置来探索这些干预措施的背景、机制和结果。
由于该综述不涉及原始数据收集，因此无需伦理批准。本综述旨在澄清研究差距，为更广泛研究、政策和实践的下一阶段提供信息。研究结果的报告将遵循现实主义综合研究的RAMESES出版标准，确保报告的透明度和严谨性。结果将通过同行评审出版物、会议报告和利益相关者团体确定的其他策略进行传播。
PROSPERO注册号：CRD42024606133。
