PDF(Pubmed)
Abstract：
The increasing elderly population is driving higher utilization rates of long-term care facilities, where residents often have multiple chronic diseases, making them potential candidates for palliative care. Timely palliative care interventions can improve their quality of life and medical autonomy. This study systematically reviews the effectiveness of palliative care programs in long-term care facilities. Databases such as PubMed, EMBASE, Cochrane Library, and Airiti Library were searched up to 31 December 2023, using PICO criteria and the following keywords: \'care home\', \'nursing home\', \'residential aged care facility\', and \'long-term care facility\' for patients; and \'Gold Standard Framework in Care Homes\', \'integrated care pathway\', \'care home project\', and \'palliative care program\' for interventions. Seven articles were included. The results indicate that the Program of All-Inclusive Care for the Elderly (PACE) intervention did not significantly influence overall quality of life but did improve the quality of death. There were no statistical differences in comfort or quality of death between the dementia and non-dementia groups. However, PACE significantly reduced healthcare costs. The implementation of the Liverpool Care Pathway (LCP) notably enhanced the control of terminal symptoms, while the Gold Standard Framework in Care Homes (GSFCH) effectively improved end-of-life care rates, do-not-resuscitate (DNR) signing rates, advance care planning (ACP) completion rates, and reduced inappropriate readmission rates. While palliative care interventions are shown to improve the quality of end-of-life care, their practical application should be adapted to fit the implementation conditions and capabilities of domestic long-term care facilities.
摘要：
不断增加的老年人口推动长期护理设施利用率提高,那里的居民经常患有多种慢性疾病，使他们成为姑息治疗的潜在候选人。及时的姑息治疗干预可以提高他们的生活质量和医疗自主权。这项研究系统地回顾了长期护理机构中姑息治疗计划的有效性。数据库，如PubMed、EMBASE,科克伦图书馆,和Airiti图书馆搜索到2023年12月31日，使用PICO标准和以下关键字：\'疗养院\',\'住宅老年护理设施\'，以及为患者提供的“长期护理设施”；以及“疗养院黄金标准框架”，“综合护理路径”，\'护理之家项目\'，和干预措施的“姑息治疗计划”。其中有七篇文章。结果表明，老年人全包护理计划（PACE）干预并未显着影响总体生活质量，但确实改善了死亡质量。痴呆组和非痴呆组之间的舒适度或死亡质量没有统计学差异。然而,PACE显著降低了医疗成本。利物浦护理路径（LCP）的实施显着增强了对晚期症状的控制，虽然护理家庭金标准框架(GSFCH)有效提高了临终关怀率，不复苏(DNR)签字率，提前护理计划(ACP)完成率，降低了不适当的再入院率。虽然姑息治疗干预被证明可以提高临终关怀的质量，它们的实际应用应适应国内长期护理设施的实施条件和能力。
