Rapid review of decision-making for place of care and death in older people: Lessons for COVID-19
Rapid review of decision-making for place of care and death in older people: Lessons for COVID-19
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DOI：
10.1192/j.eurpsy.2021.732
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发表时间：
2021-08-13
影响因子：
7.8
通讯作者：
Davies, N.
中科院分区：
文献类型：
--
作者：
West, E.;Moore, K.;Kupeli, N.;Sampson, E.;Nair, P.;Aker, N.;Davies, N.
冠状病毒大流行(新冠肺炎)影响了世界各地医疗保健系统的功能和能力。新冠肺炎对老年人的影响也不成比例，包括那些患有痴呆症的人。在新冠肺炎的背景下，围绕这一人群的护理地点和死亡地点的决策涉及重大的新挑战。探讨影响老年人护理地点和死亡地点决定的关键因素。第二个目的是调查影响老年人做出这些决定的过程和结果的关键因素。将现有证据的发现应用于新冠肺炎的背景下。根据世卫组织快速审查指南进行的快速审查。本研究共纳入10篇论文，用于完整的数据提取。这些论文发表于2005-2020年间。提取的数据通过叙述综合、专题分析和制表进行综合。论文收录讨论了实际死亡地点，以及首选。研究结果分为探讨决策过程的论文和探讨决策结果的论文。护理员能力、多学科团队的可获得性、护理包的文化适当性和高级护理计划等因素被发现是关键。老年人的决策过程和结果受到许多因素的影响--所有这些因素都有可能影响患者和照顾者的疾病和死亡经历。在新冠肺炎的背景下，这样的决定可能必须迅速做出，并反映出系统以及家庭和患者不断变化的需求。
The coronavirus pandemic (COVID-19) has affected the functioning and capacity of healthcare systems worldwide. COVID-19 has also disproportionately affected older adults, including those living with dementia. In the context of COVID-19, decision-making surrounding place of care and place of death in this population involves significant new challenges. To explore key factors that influence place of care and place of death decisions in older adults. A secondary aim was to investigate key factors that influence the process and outcome of these decisions in older adults. To apply findings from current evidence to the context of COVID-19. Rapid review of reviews, undertaken using WHO guidance for rapid reviews. Ten papers were included for full data extraction. These papers were published between 2005-2020. Data extracted was synthesised using narrative synthesis, with thematic analysis and tabulation. Papers included discussed actual place of death, as well as preferred. Results were divided into papers that explored the process of decision-making, and those that explored decision-making outcomes. Factors such as caregiver capacity, the availability of multidisciplinary teams, cultural appropriateness of care packages and advanced care planning were found to be key. The process and outcomes of decision-making for older people are affected by many factors – all of which have the potential to influence both patients and caregivers experience of illness and dying. Within the context of COVID-19, such decisions may have to be made rapidly and be reflexive to changing needs of systems and of families and patients.