Telehealth Palliative Care in Nursing Homes: A Scoping Review.
Telehealth Palliative Care in Nursing Homes: A Scoping Review.
复制标题
疗养院的远程医疗姑息治疗：范围界定审查。
DOI：
10.1016/j.jamda.2023.01.004
复制
发表时间：
2023
影响因子：
7.6
通讯作者：
Carpenter,JoanG
中科院分区：
文献类型：
--
作者：
Walton,Lyle;Courtright,Katherine;Demiris,George;Gorman,EmilyF;Jackson,Amy;Carpenter,JoanG
许多65岁以上的成年人在生命结束时在疗养院（NH）度过一段时间，那里的专业姑息治疗是有限的。然而，远程保健可能会改善姑息治疗服务的获得。进行了文献综述，以综合远程医疗姑息治疗的证据，为实践，研究和政策提供建议。以及系统性评价和Meta的首选报告项目分析扩展范围审查框架被用来指导这一文献综述。设置和病人审查的文章集中在居民在国家卫生院与远程医疗姑息治疗远程操作的护理干预人员。参与者包括NH居民，护理伙伴（S），NH工作人员/clinics.MethodsWe搜索Medline（奥维德），Embase（爱思唯尔），科克伦图书馆（WileyOnline），Scopus（爱思唯尔），CINHAL（EBSCOhost），Trip PRO和Dissertations & Theses Global（ProQuest）在2021年6月，在2022年1月更新。我们包括观察和定性研究，临床试验，质量改进项目，并自我认定为远程医疗姑息治疗NH resident.ResultsThe审查产生了11个合格的文章发表在美国和国际上从2008年至2020年的情况和临床报告。文章将现场视频描述为首选的远程保健提供方式，最常解决的是护理目标和护理的物理方面。文章中的发现集中在5个以患者和家庭为中心的结局：症状管理、生活质量、提前护理计划、医疗保健使用和护理评估。远程保健姑息治疗的持续效益包括增加了护理目标的记录，减少了急性护理的使用。缺点包括技术上的困难和增加NH的财政负担。结论和ImplicationsAlthough有限的范围和质量，目前的证据显示远程姑息治疗干预措施的承诺，提高质量和成果的严重疾病护理在NH。未来的实证研究应侧重于干预的有效性，实施结果（如，管理技术），利益相关者的经验和成本。
ObjectivesMany adults older than 65 spend time in a nursing home (NH) at the end of life where specialist palliative care is limited. However, telehealth may improve access to palliative care services. A review of the literature was conducted to synthesize the evidence for telehealth palliative care in NHs to provide recommendations for practice, research, and policy.DesignJoanna Briggs Institute guidance for scoping reviews, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews frameworks were used to guide this literature review.Settings and ParticipantsReviewed articles focused on residents in NHs with telehealth palliative care interventionists operating remotely. Participants included NH residents, care partner(s), and NH staff/clinicians.MethodsWe searched Medline (Ovid), Embase (Elsevier), Cochrane Library (WileyOnline), Scopus (Elsevier), CINHAL (EBSCOhost), Trip PRO, and Dissertations & Theses Global (ProQuest) in June 2021, with an update in January 2022. We included observational and qualitative studies, clinical trials, quality improvement projects, and case and clinical reports that self-identified as telehealth palliative care for NH residents.ResultsThe review yielded 11 eligible articles published in the United States and internationally from 2008 to 2020. Articles described live video as the preferred telehealth delivery modality with goals of care and physical aspects of care being most commonly addressed. Findings in the articles focused on 5 patient and family-centered outcomes: symptom management, quality of life, advance care planning, health care use, and evaluation of care. Consistent benefits of telehealth palliative care included increased documentation of goals of care and decrease in acute care use. Disadvantages included technological difficulties and increased NH financial burden.Conclusions and ImplicationsAlthough limited in scope and quality, the current evidence for telehealth palliative care interventions shows promise for improving quality and outcomes of serious illness care in NHs. Future empirical studies should focus on intervention effectiveness, implementation outcomes (eg, managing technology), stakeholders’ experience, and costs.