【摘要】 目的:描述国内外居家安宁疗护服务的研究现况,为我国居家安宁疗护服务的发展提供借鉴。方法:采用概括性评价的方法,检索PubMed、Web of Science、CINAHL、Scopus、OVID和中国生物医学文献数据库(Sino-Med)、中国知网(CNKI)、万方数据知识服务平台和维普中文期刊服务平台,检索时间为2009年1月1日—2019年7月1日。纳入以居家安宁疗护为主题的文献,采用Donabedian的评价框架对服务的结构、过程和结果进行描述总结。结果:纳入的92篇文献共介绍了58个国外的居家安宁服务项目和25个国内的居家安宁服务项目。国内的服务对象多为肿瘤病人,而国外的服务对象更为多元化。服务团队成员均以医生、护士为主,但国内其他学科背景的成员有待增加。服务形式均以家庭访视结合电话随访为主,但国外服务频次高于国内。护士的服务频次高于医生。安宁疗护知识宣教及死亡教育是国内服务的特色。国内文献多关注病人方面的结果指标,而国外文献更关注医疗资源相关的结果指标。结论:国内居家安宁服务可酌情扩大收治范围,完善多学科服务团队,充分发挥护士的重要作用,增加服务频次,在服务评价中可增加医疗服务体系相关的指标。更多还原

【Abstract】 Objective:To review the studies on the home-based end-of-life care both at home and aboard,in order to shine a light on the future development of the home-based end-of-life care in China.Methods:Literatures on home-based end-of-life care were searched in Pub Med,Web of science,CINAHL,Scopus,OVID,Pub Med,Sino-Med,CNKI,Wanfang data and VIP databases from January 2009 to July 2019 using summary evaluation.The literatures on home-based end-of-life care were included,and the structure,process,and outcome of services were described and summarized using the Donabedian evaluation framework.Results:A total of 92 articles including58 end-of-life care programs in foreign countries and 25 end-of-life care programs in China were reviewed.Patients in most Chinese end-of-life care programs were cancer patients,while service objects in foreign countries were more diversified.Doctors and nurses were the main care providers.The multidisciplinary team of the end-of-life care in China still need to develop.Home visits and telephone follow-ups were the most common service form.The frequency of the service in foreign countries was higher than that in China.The frequency of nurse visits were higher than that of doctor visits.The knowledge education of end-of-life care and death education were the characteristics of domestic service.Domestic literatures mostly focused on outcomes of patients,while foreign literatures focused on the outcomes related to medical resources.Conclusion:The domestic home-based end-of-life care could appropriately expand the scope of admission,build the multidisciplinary service team,give full play to the important role of nurses,increase the service frequency,and add the indicators related to the medical service system in the service evaluation.更多还原