护理SCI晨读：临终痴呆症患者的营养和水分补充：定性研究系统评价

临终痴呆症患者的营养和水分补充：定性研究系统评价

摘要

目的

综合定性证据，来汇总痴呆症患者、家庭护理人员和从业者对临终痴呆症患者的营养和水分补充的看法和体验。

设计

定性研究的系统综述和叙述性综合。

数据源

MEDLINE，Embase，PsycINFO，CINAHL。

审查方法

从数据库中搜索2000年1月至2020年2月的定性研究。不包括定量研究或报告生物学机制、评估、量表或诊断工具的研究。采用叙述性综合方法对结果进行主题分析。

结果

纳入20项研究。15项探索了从业者与长期护理机构或医院中痴呆症患者一起工作的观点。形成了四个主题：支持营养和水分的挑战；在“正确的事情”与各方意见之间取得平衡；国家背景和社会文化影响；以及在临终痴呆症患者支持营养和补水的策略。

结论

为临终痴呆症患者支持营养和补水的复杂性与国情、缺乏知识以及在人们交流时计划不足有关。

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.

原文链接：

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

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