摘要
目的:系统评价预立医疗照护计划(ACP)对心力衰竭(HF)患者临终治疗偏好的影响,为相关研究提供参考依据。方法:使用计算机检索Pubmed、Web of Science、Cochrane Library、Embase、中国知网、维普网、万方数据库从建库至2024年10月23日发表的比较ACP干预与常规护理对HF患者临终治疗偏好影响的随机对照试验(RCT),研究对象为HF患者,采用RevMan 5.3软件进行Meta分析。结果:共纳入7篇文献,包括1145例HF患者。meta分析结果显示,ACP可以影响HF患者临终治疗偏好,干预后,患者的临终治疗更偏向于追求舒适护理,减少生命延长治疗[SMD=0.49,95%CI(0.44~0.53),Z=19.77,P<0.00001]。结论:ACP能够对HF患者的临终治疗偏好产生影响,使得患者在临终治疗方面更倾向于追求舒适护理,而非一味地进行毫无意义的生命延长治疗。未来的研究应当进一步探究ACP的最佳实施时机与方法,从而最大化其对HF患者临终护理的积极效应。
Objective To systematically evaluate the impact of advance care planning(ACP)on the end-of-life treatment preferences of patients with heart failure(HF),and to provide a reference basis for related research.Methods Computer retrieval was conducted in PubMed,Web of Science,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),VIP Database,and Wanfang Database to collect randomized controlled trials(RCTs)comparing the impact of ACP intervention and conventional care on end-of-life treatment preferences in HF patients,with the study subjects being HF patients,published from the establishment of the databases to October 23,2024.Meta-analysis was performed using RevMan 5.3 software.Results A total of 7 literatures were included,involving 1145 patients with HF.The results of the meta-analysis showed that ACP could influence the end-of-life treatment preferences of HF patients.After the intervention,the end-of-life treatment of patients was more inclined to pursue comfortable care and reduce life-prolonging treatment[SMD=0.49,95%CI(0.44-0.53),Z=19.77,P<0.00001].Conclusion ACP can have an impact on the end-of-life treatment preferences of HF patients,making them more inclined to pursue comfortable care in end-of-life treatment rather than blindly undergoing meaningless life-prolonging treatment.Future research should further explore the optimal implementation timing and methods of ACP,thereby maximizing its positive effects on end-of-life care for patients with HF.
作者
蒋晓岚
于从
赵云肖
孔文萱
姚梦婷
罗秀芳
JIANG Xiaolan;YU Cong;ZHAO Yunxiao;KONG Wenxuan;YAO Mengting;LUO Xiufang(School of Nursing,Guangxi University of Chinese Medicine,Guangxi Nanning 530200;Nursing Department,Shenzhen Second People's Hospital/The First Affiliated Hospital of Shenzhen University,Guangdong Shenzhen 518035;Emergency Department,Luoyang Central Hospital,Henan Luoyang 471000)
出处
《深圳中西医结合杂志》
2025年第10期23-26,I0009,I0010,I0011,共7页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
广东省哲学社会科学创新工程特别委托项目(GD22TWCXGC02)
深圳市卫生经济学会护理经济评价专业委员会科研基金项目(HLJJYJ2023-1007)。
