目的 系统评价和整合影响生命末期患者家属抢救治疗决策的因素.方法 检索PubMed、The Cochrane Library、Web of Science、EMbase、知网、万方、维普与中国生物医学文献数据库(CMB),检索时限为建库至2022年12月,使用2017年澳大利亚JBI循证卫生保健中心质性研究文献质量评价工具评价纳入文献质量,通过汇集性整合方法进行整合.结果 共纳入13项研究,提取76个研究结果,归纳形成13个新类别,得出4个结果,患者因素(病情及生活质量、意愿表达、患者其他因素)、家庭相关因素(抢救知识与理解、照顾者经验及相关因素、决策观和死亡观、家庭态度与支持、经济因素)、医疗因素(医护人员因素、医疗设施及制度)和社会环境因素(文化及道德因素、信仰因素、社会支持).结论 终末期患者家属临终治疗决策影响因素复杂,应从个人、家庭、社会3个层面进行全方位干预,以提高临终照护质量.
Meta-integration of Qualitative Studies on Influencing Factors of Terminal Rescue Decision-making of Family Members of End-stage Patients
Objective To systematically evaluate and integrate the factors affecting the rescue and treatment decisions of family members of end-stage patients.Methods PubMed,The Cochrane Library,Web of Science,EMbase,CNKI,Wanfang,VIP and Chinese Biomedical Literature Database(CMB)were searched from inception to December 2022.The quality of the included literature was evaluated using the 2017 Australian JBI evidence-based health care center's qualitative research literature quality evaluation tool,and integrated through a pooled integration method.Results A total of 13 studies were included,76 research results were extracted,13 new categories were summarized,and 4 results were obtained,which were patient factors(condition and quality of life,willingness expression,other factors of patients),family related factors(rescue knowledge and understanding,caregiver experience and related factors,decision-making view and death view,family attitude and support,economic factors),medical factors(medical staff factors,medical facilities and systems)and social environmental factors(cultural and moral factors,belief factors,social support).Conclusion The factors influencing the decision-making of terminal care of family members of end-stage patients are complex.Comprehensive intervention should be carried out from three levels of individual,family and society to improve the quality of terminal care.
Family members of end-stage patientsTerminal careRescue decision-making
国家科技期刊平台
NSTL
万方数据
