Where the Dying Live: A Systematic Review of Determinants of Place of End-of-Life Cancer Care
Where the Dying Live: A Systematic Review of Determinants of Place of End-of-Life Cancer Care
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DOI：
10.1188/09.onf.69-77
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发表时间：
2009-01-01
影响因子：
1.9
通讯作者：
Kryworuchko, Jennifer
中科院分区：
文献类型：
--
作者：
Murray, Mary Ann;Fiset, Valerie;Kryworuchko, Jennifer
目的/目标：描述癌症患者临终关怀地点的决定因素。数据来源：对1997-2007年的主要研究进行了系统的文献回顾。检查了调查终末护理地点或确定终末护理地点与结果相关的研究，评估了其关键质量，并绘制了参考文献。数据综合：在确定的735篇文章中，39篇（代表33项研究）符合纳入标准。出现了两种主要的研究设计：大规模的流行病学报告和较小的描述性研究。研究结果表明，与疾病，个人，护理和社会环境相关的因素会影响癌症患者的EOL护理。社会支持，医疗投入（从服务和方案和医疗服务提供者的接触），和病人的喜好是最重要的factors.Conclusions：大多数晚期癌症患者喜欢家庭姑息治疗，但是，大多数死在一个机构。原因是复杂的，与各种决定因素影响的决定，关于地方的EOL care.Implications护理：调查结果可能会突出以证据为基础的干预措施，以帮助患者和家庭面临的决定，关于地方的EOL护理。更清楚地了解影响癌症患者终末期护理的因素可以加强医疗保健政策，并指导医疗保健系统的基于需求的修改。
Purpose/Objectives: To describe the determinants of place of end-of-life (EOL) care for patients with cancer.Data Sources: A systematic literature review of primary research studies (1997-2007) was conducted. Studies that investigated place of EOL care or identified place of EOL care in relation to outcomes were examined, their critical quality was appraised, and references were mapped.Data Synthesis: Of the 735 articles identified, 39 (representing 33 studies) met inclusion criteria. Two main research designs emerged: large-scale epidemiologic reports and smaller descriptive studies. Findings suggest that factors related to the disease, the individual, and the care and social environment influence place of EOL care for patients with cancer. Social support, healthcare inputs (from services and programs and healthcare provider contact), and patient preferences were the most important factors.Conclusions: Most patients with terminal cancer prefer home palliation; however, most die in an institution. The reasons are complex, with various determinants influencing decisions regarding place of EOL care.Implications for Nursing: Findings may highlight evidence-based interventions to assist patients and families facing decisions regarding place of EOL care. A clearer understanding of factors that influence place of EOL care for patients with cancer could enhance healthcare policy and guide needs-based modifications of the healthcare system.