臨終癡呆癥患者的營養(yǎng)和水分補充：定性研究系統(tǒng)評價

摘要

目的

綜合定性證據(jù)，來匯總癡呆癥患者、家庭護理人員和從業(yè)者對臨終癡呆癥患者的營養(yǎng)和水分補充的看法和體驗。

設計

定性研究的系統(tǒng)綜述和敘述性綜合。

數(shù)據(jù)源

MEDLINE，Embase，PsycINFO，CINAHL。

審查方法

從數(shù)據(jù)庫中搜索2000年1月至2020年2月的定性研究。不包括定量研究或報告生物學機制、評估、量表或診斷工具的研究。采用敘述性綜合方法對結果進行主題分析。

結果

納入20項研究。15項探索了從業(yè)者與長期護理機構或醫(yī)院中癡呆癥患者一起工作的觀點。形成了四個主題：支持營養(yǎng)和水分的挑戰(zhàn)；在“正確的事情”與各方意見之間取得平衡；國家背景和社會文化影響；以及在臨終癡呆癥患者支持營養(yǎng)和補水的策略。

結論

為臨終癡呆癥患者支持營養(yǎng)和補水的復雜性與國情、缺乏知識以及在人們交流時計劃不足有關。

英文摘要

To synthesize the qualitative evidence of the views and experiences of people living with dementia, family carers, and practitioners on practice related to nutrition and hydration of people living with dementia who are nearing end of life.

Design

Systematic review and narrative synthesis of qualitative studies.

Data sources

MEDLINE, Embase, PsycINFO, CINAHL.

Review methods

Databases were searched for qualitative studies from January 2000‐February 2020. Quantitative studies, or studies reporting on biological mechanisms, assessments, scales or diagnostic tools were excluded. Results were synthesized using a narrative synthesis approach with thematic analysis.

Results

Twenty studies were included; 15 explored the views of practitioners working with people living with dementia in long‐term care settings or in hospitals. Four themes were developed: challenges of supporting nutrition and hydration; balancing the views of all parties involved with ‘the right thing to do’; national context and sociocultural influences; and strategies to support nutrition and hydration near the end of life in dementia.

Conclusion

The complexity of supporting nutrition and hydration near the end of life for someone living with dementia relates to national context, lack of knowledge, and limited planning while the person can communicate.

Impact

This review summarizes practitioners and families’ experiences and highlights the need to include people living with dementia in studies to help understand their views and preferences about nutrition and hydration near the end of life; and those of their families supporting them in the community. The review findings are relevant to multidisciplinary teams who can learn from strategies to help with nutrition and hydration decisions and support.

原文鏈接：

https://onlinelibrary.wiley.com/doi/full/10.1111/jan.14654

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