Abstract：
BACKGROUND: Early referral to palliative care has been viewed as providing opportunity for accomplishing end-of-life care goals of life closure, comfortable dying and effective grieving. However, previous studies have shown that palliative care referrals are being made too late. Healthcare providers play important role in helping terminally ill patients to early access and being referred to palliative care. It is necessary to understand healthcare providers\' attitudes on palliative care referral and associated factors regarding referrals.
OBJECTIVE: This review aimed to identify and synthesise healthcare providers\' attitudes and associated factors on palliative care referrals systematically.
METHODS: A systematic review of qualitative evidence and meta-aggregation was conducted and guided according to PRISMA guideline.
METHODS: PubMed, CINAHL, PsycINFO, EMBASE, Web of Science and Cochrane databases from inception to 24 October 2022.
RESULTS: Database searches yielded 5856 references. Twenty-two studies met eligibility criteria and of moderate to high methodological quality were included. Studies occurred in USA, UK, Australia and France with 716 healthcare providers participants were included. A total of 378 codings were finally extracted and integrated into 41 categories, forming three synthesised findings: (1) Healthcare providers\' attitudes towards palliative care referrals, (2) the influence of subjective norms on palliative care referral behaviour and (3) perceived behavioural control on palliative care referral behaviour.
CONCLUSIONS: This review demonstrates a series of factors that affect the palliative care referrals, including the attitudes of healthcare providers, the participation of patients and families, the support of colleagues and supervisors, inter-professional collaboration, the availability of hospice resource, disease trajectory and socio-economic factors. Further research that addresses these factors and design relevant trainings on improving healthcare providers\' attitudes, enhancing patient and family engagement, strengthening support networks and optimising resource allocation may aid to meet increasing demands of patients.
CONCLUSIONS: This review not only guides healthcare providers in making better decisions about patient referrals by identifying and addressing barriers but also aids in the development of effective interventions that facilitate the early initiation of referrals.
UNASSIGNED: No patient or public contribution.
OBJECTIVE: This review aimed to identify and synthesise healthcare providers\' attitudes and associated factors on palliative care referrals systematically.
METHODS: A systematic review of qualitative evidence and meta-aggregation was conducted and guided according to PRISMA guideline.
METHODS: PubMed, CINAHL, PsycINFO, EMBASE, Web of Science and Cochrane databases from inception to 24 October 2022.
RESULTS: Database searches yielded 5856 references. Twenty-two studies met eligibility criteria and of moderate to high methodological quality were included. Studies occurred in USA, UK, Australia and France with 716 healthcare providers participants were included. A total of 378 codings were finally extracted and integrated into 41 categories, forming three synthesised findings: (1) Healthcare providers\' attitudes towards palliative care referrals, (2) the influence of subjective norms on palliative care referral behaviour and (3) perceived behavioural control on palliative care referral behaviour.
CONCLUSIONS: This review demonstrates a series of factors that affect the palliative care referrals, including the attitudes of healthcare providers, the participation of patients and families, the support of colleagues and supervisors, inter-professional collaboration, the availability of hospice resource, disease trajectory and socio-economic factors. Further research that addresses these factors and design relevant trainings on improving healthcare providers\' attitudes, enhancing patient and family engagement, strengthening support networks and optimising resource allocation may aid to meet increasing demands of patients.
CONCLUSIONS: This review not only guides healthcare providers in making better decisions about patient referrals by identifying and addressing barriers but also aids in the development of effective interventions that facilitate the early initiation of referrals.
UNASSIGNED: No patient or public contribution.
摘要：
背景：早期转诊姑息治疗被视为为实现生命结束护理目标提供了机会，舒适的死亡和有效的悲伤。然而,先前的研究表明，姑息治疗转诊为时已晚。医疗保健提供者在帮助绝症患者尽早获得姑息治疗和转介姑息治疗方面发挥着重要作用。有必要了解医疗保健提供者对姑息治疗转诊的态度以及转诊的相关因素。
目的：这篇综述旨在系统地识别和综合医疗保健提供者对姑息治疗转诊的态度和相关因素。
方法：根据PRISMA指南对定性证据和meta聚集进行系统评价。
方法：PubMed，CINAHL,PsycINFO,EMBASE,WebofScience和Cochrane数据库从成立到2022年10月24日。
结果：数据库搜索产生5856个参考。包括22项符合资格标准且方法学质量中等至高的研究。研究发生在美国，英国,澳大利亚和法国有716名医疗保健提供者参与者。最终总共提取了378个编码，并将其整合到41个类别中，形成三个综合发现：(1)医疗保健提供者对姑息治疗转介的态度，（2）主观规范对姑息治疗转诊行为的影响；（3）感知行为控制对姑息治疗转诊行为的影响。
结论：本综述证明了一系列影响姑息治疗转诊的因素，包括医疗服务提供者的态度，患者和家属的参与，同事和主管的支持，跨专业合作，临终关怀资源的可用性，疾病发展轨迹和社会经济因素。进一步研究解决这些因素，并设计相关培训，以改善医疗保健提供者的态度，增强患者和家庭的参与度，加强支持网络和优化资源分配可能有助于满足患者日益增长的需求。
结论：本综述不仅指导医疗保健提供者通过识别和解决障碍来更好地决定患者转诊，而且还有助于制定有效的干预措施，促进早期开始转诊。
■没有患者或公众捐款。
目的：这篇综述旨在系统地识别和综合医疗保健提供者对姑息治疗转诊的态度和相关因素。
方法：根据PRISMA指南对定性证据和meta聚集进行系统评价。
方法：PubMed，CINAHL,PsycINFO,EMBASE,WebofScience和Cochrane数据库从成立到2022年10月24日。
结果：数据库搜索产生5856个参考。包括22项符合资格标准且方法学质量中等至高的研究。研究发生在美国，英国,澳大利亚和法国有716名医疗保健提供者参与者。最终总共提取了378个编码，并将其整合到41个类别中，形成三个综合发现：(1)医疗保健提供者对姑息治疗转介的态度，（2）主观规范对姑息治疗转诊行为的影响；（3）感知行为控制对姑息治疗转诊行为的影响。
结论：本综述证明了一系列影响姑息治疗转诊的因素，包括医疗服务提供者的态度，患者和家属的参与，同事和主管的支持，跨专业合作，临终关怀资源的可用性，疾病发展轨迹和社会经济因素。进一步研究解决这些因素，并设计相关培训，以改善医疗保健提供者的态度，增强患者和家庭的参与度，加强支持网络和优化资源分配可能有助于满足患者日益增长的需求。
结论：本综述不仅指导医疗保健提供者通过识别和解决障碍来更好地决定患者转诊，而且还有助于制定有效的干预措施，促进早期开始转诊。
■没有患者或公众捐款。
