背景:提前护理计划涉及讨论个人未来的医疗和护理偏好。护士,由于他们与患者和家人的密切关系,可能有能力领导这些讨论。探索护士主导的ACP干预措施的组成部分和特征对于加强其实施至关重要,有效性,和可持续性。
目的:本范围综述旨在探讨护士主导的成人患者ACP干预措施的特点,确定使用这些干预措施的人群和环境,以及美国这些干预措施的结果
方法:根据Arksey和O\'Malley的五阶段框架进行了范围审查。使用与护士主导的ACP干预措施相关的关键词,在PubMed进行了全面的搜索,WebofScience,CINAHL,EMBASE,和PsycINFO数据库。
结果:12项研究符合纳入标准。这些研究是在不同的环境中进行的。注册护士,肿瘤科护士领航员,和其他专业护士主要提供护士主导的ACP干预措施。干预措施从一到两次会议不等,并利用了各种模式和资源,例如五个愿望和尊重选择。
结论:护士主导的ACP干预措施显示出显著的积极效果,包括增加对ACP的参与,改善对广告的态度,广告完成率更高,并增强了患者代孕一致性。这些干预措施深受患者欢迎,可以在不同的环境中实施。然而,需要关于护士主导的ACP干预措施的一般指南来解决具体的持续时间,会话,以及最佳有效性所需的交付方式。
BACKGROUND: Advance care planning involves discussing individuals\' future medical treatment and care preferences. Nurses, due to their close relationships with patients and families, may be well-positioned to lead these discussions. Exploring the components and characteristics of nurse-led ACP interventions is essential for enhancing their implementation, effectiveness, and sustainability.
OBJECTIVE: This scoping review aimed to explore the characteristics of nurse-led ACP interventions in adult patients, identify the populations and settings where these interventions have been utilized, and the outcomes of these interventions in the U.S.
METHODS: A scoping review was conducted following Arksey and O\'Malley\'s five-stage framework. Using keywords related to nurse-led ACP interventions, a comprehensive search was performed across PubMed, Web of Science, CINAHL, EMBASE, and PsycINFO databases.
RESULTS: Twelve studies met the inclusion criteria. These studies were conducted in varied settings. Registered nurses, oncology nurse navigators, and other specialized nurses primarily delivered nurse-led ACP interventions. The interventions ranged from one to two sessions and utilized various models and resources such as the Five Wishes and Respecting Choices.
CONCLUSIONS: Nurse-led ACP interventions have shown significant positive outcomes, including increased engagement in ACP, improved attitudes towards ADs, higher completion rates of ADs, and enhanced patient-surrogate congruence. These interventions are well-received by patients and can be implemented in diverse settings. However, a general guideline regarding nurse-led ACP interventions is needed to address the specific duration, sessions, and mode of delivery required for their optimal effectiveness.