PDF(Pubmed)
Abstract：
Digital approaches to support advance care planning (ACP) documentation and sharing are increasingly being used, with a lack of research to characterise their design, content, and use. This study aimed to characterise how digital approaches are being used to support ACP documentation and sharing internationally. A scoping review was performed in accordance with the JBI (formerly Joanna Briggs Institute) guidelines and the PRISMA 2020 checklist, prospectively registered on Open Science Framework (https://osf.io/xnrg3). MEDLINE, EMBASE, PsycINFO, ACM Digital, IEEE Xplore and CINAHL were searched in February 2023. Only publications in English, published from 2008 onwards were considered. Eligibility criteria included a focus on ACP and electronic systems. Out of 2,393 records, 34 reports were included, predominantly from the USA (76.5%). ACP documentation is typically stored in electronic health records (EHRs) (67.6%), with a third (32.4%) enabling limited patient access. Non-standard approaches (n = 15;44.1%) were the commonest study design of included reports, with outcome measures focusing on the influence of systems on the documentation (i.e. creation, quantity, quality, frequency or timing) of ACP information (n = 23;67.6%). Digital approaches to support ACP are being implemented and researched internationally with an evidence base dominated by non-standard study designs. Future research is needed to extend outcome measurement to consider aspects of care quality and explore whether the content of existing systems aligns with aspects of care that are valued by patients.
摘要：
支持高级护理计划（ACP）文档和共享的数字方法越来越多地被使用，缺乏研究来描述他们的设计，内容,和使用。这项研究旨在描述如何使用数字方法来支持ACP文档和国际共享。根据JBI（以前的JoannaBriggs研究所）指南和PRISMA2020清单进行了范围审查，预期在开放科学框架(https://osf.io/xnrg3)上注册。MEDLINE,EMBASE,PsycINFO,ACM数字,IEEEXplore和CINAHL于2023年2月进行了搜索。只有英文出版物，从2008年开始出版的。资格标准包括对ACP和电子系统的关注。在2393条记录中,包括34份报告，主要来自美国（76.5%）。ACP文档通常存储在电子健康记录（EHR）中（67.6％），三分之一(32.4%)允许有限的患者进入。非标准方法（n=15;44.1％）是纳入报告中最常见的研究设计，结果度量侧重于系统对文档的影响(即创建，数量,质量,频率或定时)ACP信息(n=23；67.6%)。支持ACP的数字方法正在国际上实施和研究，其证据基础由非标准研究设计主导。需要进行未来的研究来扩展结果测量，以考虑护理质量的各个方面，并探索现有系统的内容是否与患者重视的护理方面保持一致。
