OBJECTIVE: To provide an updated synthesis of the literature on the wish to hasten death in people with life-limiting conditions.
METHODS: An overview of systematic reviews and primary studies was conducted, using an integrative review method. PubMed, CINAHL, Scopus and Web of Science databases were searched, from their inception until 2023. We included all systematic reviews published to date and all primary studies not included in these systematic reviews.
RESULTS: Eleven systematic reviews and 35 primary studies were included. We propose that the phenomenon may usefully be considered as existing along a continuum, defined by the extent to which thoughts of dying are linked to action. A total of nine assessment tools have been described. The reported prevalence of the wish to hasten death appears to be influenced by the wording used in assessment instruments, as well as by the cut-off used when applying a particular tool. Depression, pain, functional disability, decreased sense of meaning in life, the sense of being a burden and reduced quality of life are the most widely reported related factors.
CONCLUSIONS: This overview underscores the need for clinical strategies that can identify different manifestations of the wish to hasten death among people with life-limiting conditions.
目的:提供有关希望加速生命受限患者死亡的文献的最新综合。
方法:进行了系统综述和初步研究,使用综合审查方法。PubMed,CINAHL,搜索了Scopus和WebofScience数据库,从成立到2023年。我们纳入了迄今为止发表的所有系统综述和未纳入这些系统综述的所有主要研究。
结果:共纳入11项系统评价和35项主要研究。我们建议这种现象可以被认为是沿着连续体存在的,由死亡的思想与行动的联系程度来定义。共描述了九种评估工具。据报告,希望加速死亡的普遍性似乎受到评估工具中使用的措辞的影响,以及应用特定工具时使用的截止。抑郁症,疼痛,功能性残疾,生活意义的降低,负担感和生活质量下降是最广泛报道的相关因素。
结论:本概述强调了临床策略的必要性,该策略可以识别有生命限制条件的人群中加速死亡的愿望的不同表现。