A Systematic Review of Nursing Home Palliative Care Interventions: Characteristics and Outcomes |
| |
| Institution: | 1. University of Pennsylvania School of Nursing, Philadelphia, PA;2. Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA;3. University of Pennsylvania National Clinician Scholars Program, Philadelphia, PA;4. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA;1. School of Nursing, University of Rochester, Rochester, NY;2. Department of Medicine, University of Rochester Medical Center, Rochester, NY;3. University of Rochester Medical Home Care, Rochester, NY;4. Finger Lakes Geriatric Education Center, NY;5. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY;6. School of Nursing, Columbia University, New York, NY;7. School of Nursing, University of Minnesota, Minneapolis, MN;8. Department of Public Health Sciences, University of Rochester, Rochester, NY;1. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands;2. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice & Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam, the Netherlands;3. Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands;4. Radboud university medical center, Department of Primary and Community Care, Nijmegen, The Netherlands;5. International Observatory on End-of-Life Care, Lancaster University, Lancaster, United Kingdom;6. End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium;7. Department of Internal Medicine & Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy;8. National Institute for Health and Welfare, Helsinki, Finland;9. Unit for Research on Ageing Society, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland;1. ASLTO1 Torino, Via Gradisca 10, 10100 Turin, Italy;2. S. Giovanni Hospital, Corso Bramante 88, 10100 Turin, Italy;3. Department of Public Health and Paediatric Sciences, Turin University, Via Santena 5 bis, 10100 Turin, Italy;1. Department of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY;2. Department of Medicine, University of Rochester School of Medicine, Rochester, NY;3. University of Rochester, School of Nursing, Rochester, NY;4. Department of Biostatistics and Computational Biology, University of Rochester School of Medicine, Rochester, NY;5. Department of Medicine, Health Policy and Research Center, University of California, Irvine, Irvine, CA;1. Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia;2. Department of Advance Care Planning, Northern Health, Epping, Victoria, Australia |
| |
| Abstract: | BackgroundDespite recommendations to integrate palliative care into nursing home care, little is known about the most effective ways to meet this goal.ObjectiveTo examine the characteristics and effectiveness of nursing home interventions that incorporated multiple palliative care domains (eg, physical aspects of care—symptom management, and ethical aspects—advance care planning).DesignSystematic review.MethodsWe searched MEDLINE via PubMed, Embase, CINAHL, and Cochrane Library's CENTRAL from inception through January 2019. We included all randomized and nonrandomized trials that compared palliative care to usual care and an active comparator. We assessed the type of intervention, outcomes, and the risk of bias.ResultsWe screened 1167 records for eligibility and included 13 articles. Most interventions focused on staff education and training strategies and on implementing a palliative care team. Many interventions integrated advance care planning initiatives into the intervention. We found that palliative care interventions in nursing homes may enhance palliative care practices, including processes to assess and manage pain and symptoms. However, inconsistent outcomes and high or unclear risk of bias among most studies requires results to be interpreted with caution.Conclusions and ImplicationsHeterogeneity in methodology, findings, and study bias within the existing literature revealed limited evidence for nursing home palliative care interventions. Findings from a small group of diverse clinical trials suggest that interventions enhanced nursing home palliative care and improved symptom assessment and management processes. |
| |
| Keywords: | Nursing homes clinical trials palliative care end-of-life care interventions |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
