Abstract：
BACKGROUND: Advance care planning is typically initiated during the last six months of a patient\'s life. However, due to the progressive decline in the decision-making process in individuals with dementia, their involvement in advance care planning is limited to the early stages of the disease. Currently, there is no consensus on the optimal timing for initiating advance care planning for people with dementia, and a comprehensive review of the literature addressing this matter is lacking.
OBJECTIVE: To explore the experiences and perspectives of people with dementia, their family caregivers, and health care professionals with regard to the optimal timing for initiating advance care planning.
METHODS: A meta-synthesis was conducted.
METHODS: The following eight electronic databases were searched: PubMed, Embase, Web of Science, Cochrane Library, CINAHL and CNKI, WanFang and Vip.
METHODS: This review uses thematic synthesis to systematically synthesize qualitative evidence and report findings according to The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and the Joanna Briggs Institute Manual for Evidence Synthesis. Study selection and data extraction were conducted independently by two researchers, and quality was evaluated using the Joanna Briggs Institute\'s Qualitative Research Standard Assessment tool.
RESULTS: Twenty-one studies were selected for this review. This review involved an overarching theme: The utilization of pivotal elements to transition from delayed initiation to comprehensive implementation. Three themes emerge, including the prerequisites for initiating advance care planning, not ready to start advance care planning and struggling along narrow roads. For health care professionals, the selection of an opportune moment to initiate advance care planning for people with dementia is not only a challenge but also a crucial prerequisite for the successful implementation of advance care planning. Health care professionals\' experience, attitude toward advance care planning, trust relationship with patients, cultural differences among people with dementia and their caregivers, and economic disparities all influence health care professionals\' judgment of the timing for initiating advance care planning.
CONCLUSIONS: Determining the optimal timing for initiating advance care planning is a complex process that requires a comprehensive consideration of the realities faced by health care professionals, people with dementia and their caregivers. Therefore, it is imperative to provide relevant training to health care professionals to ensure the successful implementation of advance care planning.
OBJECTIVE: To explore the experiences and perspectives of people with dementia, their family caregivers, and health care professionals with regard to the optimal timing for initiating advance care planning.
METHODS: A meta-synthesis was conducted.
METHODS: The following eight electronic databases were searched: PubMed, Embase, Web of Science, Cochrane Library, CINAHL and CNKI, WanFang and Vip.
METHODS: This review uses thematic synthesis to systematically synthesize qualitative evidence and report findings according to The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and the Joanna Briggs Institute Manual for Evidence Synthesis. Study selection and data extraction were conducted independently by two researchers, and quality was evaluated using the Joanna Briggs Institute\'s Qualitative Research Standard Assessment tool.
RESULTS: Twenty-one studies were selected for this review. This review involved an overarching theme: The utilization of pivotal elements to transition from delayed initiation to comprehensive implementation. Three themes emerge, including the prerequisites for initiating advance care planning, not ready to start advance care planning and struggling along narrow roads. For health care professionals, the selection of an opportune moment to initiate advance care planning for people with dementia is not only a challenge but also a crucial prerequisite for the successful implementation of advance care planning. Health care professionals\' experience, attitude toward advance care planning, trust relationship with patients, cultural differences among people with dementia and their caregivers, and economic disparities all influence health care professionals\' judgment of the timing for initiating advance care planning.
CONCLUSIONS: Determining the optimal timing for initiating advance care planning is a complex process that requires a comprehensive consideration of the realities faced by health care professionals, people with dementia and their caregivers. Therefore, it is imperative to provide relevant training to health care professionals to ensure the successful implementation of advance care planning.
摘要：
背景：预先护理计划通常在患者生命的最后六个月开始。然而,由于痴呆症患者的决策过程逐渐下降，他们参与预先护理计划仅限于疾病的早期阶段。目前,对于启动痴呆症患者的提前护理计划的最佳时机没有共识，缺乏对解决这一问题的文献的全面审查。
目的：探索痴呆症患者的经历和观点，他们的家庭照顾者，和卫生保健专业人员关于启动提前护理计划的最佳时机。
方法：进行元合成。
方法：搜索了以下八个电子数据库：PubMed，Embase,WebofScience,科克伦图书馆,CINAHL和CNKI，万方和贵宾。
方法：本综述使用主题综合方法，根据《提高报告质量研究综合的透明度》（ENTREQ）和JoannaBriggsInstitute证据综合手册》系统地综合定性证据并报告发现。研究选择和数据提取由两名研究人员独立进行，使用乔安娜·布里格斯研究所的定性研究标准评估工具对质量进行评估。
结果：本综述选择了21项研究。这次审查涉及一个总体主题：利用关键要素从延迟启动过渡到全面执行。出现了三个主题，包括启动预先护理计划的先决条件，还没有准备好开始提前护理计划，并在狭窄的道路上苦苦挣扎。对于医疗保健专业人员来说，选择合适的时机启动痴呆症患者的提前护理计划不仅是一项挑战，也是成功实施提前护理计划的关键前提。卫生保健专业人员的经验，对提前护理计划的态度，与患者的信任关系，痴呆症患者和他们的照顾者之间的文化差异，和经济差异都会影响医疗保健专业人员对启动提前护理计划的时机的判断。
结论：确定启动预先护理计划的最佳时机是一个复杂的过程，需要全面考虑卫生保健专业人员所面临的现实，痴呆症患者和他们的照顾者。因此,必须向卫生保健专业人员提供相关培训，以确保成功实施预先护理计划。
目的：探索痴呆症患者的经历和观点，他们的家庭照顾者，和卫生保健专业人员关于启动提前护理计划的最佳时机。
方法：进行元合成。
方法：搜索了以下八个电子数据库：PubMed，Embase,WebofScience,科克伦图书馆,CINAHL和CNKI，万方和贵宾。
方法：本综述使用主题综合方法，根据《提高报告质量研究综合的透明度》（ENTREQ）和JoannaBriggsInstitute证据综合手册》系统地综合定性证据并报告发现。研究选择和数据提取由两名研究人员独立进行，使用乔安娜·布里格斯研究所的定性研究标准评估工具对质量进行评估。
结果：本综述选择了21项研究。这次审查涉及一个总体主题：利用关键要素从延迟启动过渡到全面执行。出现了三个主题，包括启动预先护理计划的先决条件，还没有准备好开始提前护理计划，并在狭窄的道路上苦苦挣扎。对于医疗保健专业人员来说，选择合适的时机启动痴呆症患者的提前护理计划不仅是一项挑战，也是成功实施提前护理计划的关键前提。卫生保健专业人员的经验，对提前护理计划的态度，与患者的信任关系，痴呆症患者和他们的照顾者之间的文化差异，和经济差异都会影响医疗保健专业人员对启动提前护理计划的时机的判断。
结论：确定启动预先护理计划的最佳时机是一个复杂的过程，需要全面考虑卫生保健专业人员所面临的现实，痴呆症患者和他们的照顾者。因此,必须向卫生保健专业人员提供相关培训，以确保成功实施预先护理计划。
