背景:报废交流是高质量护理的重要组成部分,但其改善护理的潜在机制尚不清楚。
目的:总结在任何情况下,临终沟通可能有助于增强临终护理的潜在机制。
方法:系统综述,结果的叙事综合。遵循系统评价和荟萃分析指南的首选报告项目。使用AMSTAR(评估评论的计量工具)工具评估研究质量。
方法:CINAHL,MEDLINE,科克伦,SSCI和PsycINFO数据库,从成立之初到2024年1月进行了搜索。还进行了手动搜索。
方法:与临终沟通有关的系统评价(以英文发表),目标人群是成年患者生命的最后一年,亲戚,参与与垂死患者沟通的护理人员和/或医疗保健专业人员。
结果:我们回顾了35项符合条件的研究。评论提出了有效的生命终结沟通的潜在机制,包括协作决策,为个人量身定制交流,使用有效的沟通策略,并将沟通技巧融入实践。评论还强调了与患者相关的障碍,专业人士和组织。
结论:这篇综述强调了对临终沟通的潜在机制的细致理解,强调需要量身定制的培训,政策增强和跨专业合作。它呼吁医疗保健专业人员反思他们的做法,倡导共同设计一个以人为本的沟通模型,解决病人的喜好在生命的尽头。重要的是,在不同文化的背景下,需要一种拥抱多样性的交流范式,以提供真正的同理心和有效的临终护理。这个简洁的路线图可能会培养同情心,有尊严和有效的临终沟通。
背景:在PROSPERO注册的协议(CRD42022271433,2022年3月29日)。
BACKGROUND: End-of-life communication is an essential component of high-quality care, but its potential mechanisms for improving care are not well understood.
OBJECTIVE: To summarise the potential mechanisms by which end-of-life communication may contribute to enhanced end-of-life care in any setting.
METHODS: An overview of systematic reviews, with a narrative synthesis of results. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study quality was assessed using the AMSTAR (A MeaSurement Tool to Assess Reviews) tool.
METHODS: CINAHL, MEDLINE, Cochrane, SSCI and PsycINFO databases, were searched from inception to January 2024. Manual searches were also conducted.
METHODS: Systematic reviews (published in English) related to end-of-life communication, where the target population was adult patients in their last year of life, relatives, caregivers and/or healthcare professionals involved in communicating with dying patients.
RESULTS: We reviewed 35 eligible studies. The reviews suggest potential mechanisms of effective end-of-life communication including collaborative decision-making, tailoring communication to individuals, using effective communication strategies and incorporating communication skills into practice. The reviews also highlighted barriers related to patients, professionals and organisations.
CONCLUSIONS: This review highlights a nuanced understanding of potential mechanisms of end-of-life communication, emphasising the need for tailored training, policy enhancements and interprofessional collaboration. It calls on healthcare professionals to reflect on their practices, advocating for co-designing a person-centred communication model that addresses patient preferences at the end of life. Importantly, in culturally diverse contexts, there is a need for a communication paradigm that embraces diversity to provide truly empathetic and effective end-of-life care. This concise roadmap may foster compassionate, dignified and effective end-of-life communication.
BACKGROUND: Protocol registered with PROSPERO (CRD42022271433, 29 March 2022).