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早期姑息治疗对癌症患者照顾者生活质量的影响:系统评价。

Impact of early palliative care on the quality of life in caregivers of cancer patients: A systematic review.

机构信息

Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

School of Nursing, Faculty of Medicine, Lambung Mangkurat University, Banjarbaru, Indonesia.

出版信息

Worldviews Evid Based Nurs. 2023 Jun;20(3):178-190. doi: 10.1111/wvn.12629. Epub 2023 Jan 13.

Abstract

BACKGROUND

Maintaining caregivers' quality of life (QoL) is critical to sustaining the care needed for cancer patients. One of the interventions applied to cancer patients' caregivers is early palliative care (EPC).

AIMS

This systematic review synthesized the implementation of EPC on the QoL of caregivers of cancer patients.

METHODS

The search was undertaken using seven electronic databases: Medline, Embase, CINAHL, CENTRAL, Web of Science, Scopus, and ProQuest Dissertation & Theses (PQDT). The search strategy integrated relevant terms of early palliative care, caregivers, cancer, and quality of life and was conducted until March 14, 2022. The thematic data analysis approach was used to integrate the results.

RESULTS

Using advanced search features, 4193 studies were obtained on the initial search. After screening and quality assessment, eight studies were included. Eight studies depicted that EPC interventions were delivered for caregivers of patients with advanced cancer, that is, those with a life expectancy of at least 4-24 months or considered intermediate to poor prognosis. One study provided the intervention for caregivers of patients newly diagnosed with cancer. None of the studies had the same protocol or content in delivering EPC for caregivers. Four studies gave similar details on addressing the strategies for caregivers in several aspects, including physical, psychological, social, and spiritual. There was no difference in the QoL between caregivers with cancer patients who received EPC compared with usual care. EPC was noted to influence other factors, such as caregivers' psychological distress and burden.

LINKING EVIDENCE TO ACTION

The data on EPC interventions portray no beneficial effects on the QoL of caregivers with cancer patients. Further studies on developing standard protocols of EPC, multidisciplinary team, and how early it should be given to caregivers are strongly recommended.

摘要

背景

维持照顾者的生活质量(QoL)对于维持癌症患者所需的护理至关重要。应用于癌症患者照顾者的干预措施之一是早期姑息治疗(EPC)。

目的

本系统评价综合了 EPC 对癌症患者照顾者 QoL 的实施情况。

方法

使用七个电子数据库(Medline、Embase、CINAHL、CENTRAL、Web of Science、Scopus 和 ProQuest Dissertation & Theses(PQDT))进行搜索。搜索策略整合了早期姑息治疗、照顾者、癌症和生活质量的相关术语,并于 2022 年 3 月 14 日进行了搜索。采用主题数据分析方法对结果进行整合。

结果

使用高级搜索功能,在初始搜索中获得了 4193 项研究。经过筛选和质量评估,纳入了 8 项研究。8 项研究描述了 EPC 干预措施是为患有晚期癌症的患者的照顾者提供的,即那些预期寿命至少为 4-24 个月或被认为预后中等至较差的患者。有一项研究为新诊断为癌症的患者的照顾者提供了干预措施。没有一项研究在为照顾者提供 EPC 方面有相同的方案或内容。四项研究在几个方面提供了相似的细节,包括身体、心理、社会和精神方面,为照顾者提供了应对策略。接受 EPC 的癌症患者照顾者的生活质量与接受常规护理的照顾者没有差异。EPC 被认为会影响其他因素,如照顾者的心理困扰和负担。

将证据付诸行动

关于 EPC 干预措施的数据表明,对癌症患者照顾者的生活质量没有有益的影响。强烈建议进一步研究制定 EPC 的标准方案、多学科团队以及应该多早为照顾者提供 EPC。

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