越来越多的家庭照顾者在社区环境中提供非正式照顾。这带来了许多挑战,因为家庭照顾者面临身体和心理健康状况不佳的风险,对他们自己和他们提供护理的人都有后果。全科医生(GP),他们在社区护理中起着核心作用,理想的定位是识别,评估,和路标看护人员支持。然而,在支持他们担任这一角色的适当指导和资源方面,文献中存在显著差距。
进行了范围审查,以检查临床指南和全科医生的建议,以支持他们在家庭照顾者中的作用。这涉及到一个多学科小组,符合Arksey&O\'Malley\的框架,并在2020年9月至11月之间搜索了10个同行评审数据库和灰色文献。
搜索总共产生了4,651篇英语论文,其中35个在删除重复项后符合纳入标准,筛选标题和摘要,并进行全文阅读。十篇论文侧重于全科医生的资源/指导方针,二十篇是研究论文,三个是评论文件,一个是照顾者支持的质量标记框架,一个是社论。数据综合表明,九项(90%)准则包括一些与识别有关的要素,评估,和/或看护者的路标。确定护理人员的关键策略表明,整体实践方法是最佳的,合并GP的角色,工作人员实践,并使用适当的支持文档。在适当的临床评估和基于证据的路标途径方面,强调了重要的知识差距。
我们的综述通过提供关于全科医生支持家庭照顾者的临床指南的当前可用证据的重要综合,解决了文献中的一个显著差距。包括识别策略,评估选项和潜在的转诊/路标路线。然而,有必要提高现有证据基础的透明度,以及更多的研究来评估有效性和增加常规利用率,初级保健临床指南。
Increasing numbers of family carers are providing informal care in community settings. This creates a number of challenges because family carers are at risk of poor physical and psychological health outcomes, with consequences both for themselves and those for whom they provide care. General Practitioners (GPs), who play a central role in community-based care, are ideally positioned to identify, assess, and signpost carers to supports. However, there is a significant gap in the literature in respect of appropriate guidance and resources to support them in this role.
A scoping review was undertaken to examine clinical
guidelines and recommendations for GPs to support them in their role with family carers. This involved a multidisciplinary team, in line with Arksey & O\'Malley\'s framework, and entailed searches of ten peer-reviewed databases and grey literature between September-November 2020.
The searches yielded a total of 4,651 English language papers, 35 of which met the criteria for inclusion after removing duplicates, screening titles and abstracts, and performing full-text readings. Ten papers focused on resources/
guidelines for GPs, twenty were research papers, three were review papers, one was a framework of quality markers for carer support, and one was an editorial. Data synthesis indicated that nine (90%) of the
guidelines included some elements relating to the identification, assessment, and/or signposting of carers. Key strategies for identifying carers suggest that a whole practice approach is optimal, incorporating a role for the GP, practice staff, and for the use of appropriate supporting documentation. Important knowledge gaps were highlighted in respect of appropriate clinical assessment and evidence-based signposting pathways.
Our review addresses a significant gap in the literature by providing an important synthesis of current available evidence on clinical
guidelines for GPs in supporting family carers, including strategies for identification, options for assessment and potential referral/signposting routes. However, there is a need for greater transparency of the existing evidence base as well as much more research to evaluate the effectiveness and increase the routine utilisation, of clinical
guidelines in primary care.