护理学报 ›› 2022, Vol. 29 ›› Issue (5): 37-41.doi: 10.16460/j.issn1008-9969.2022.05.037
轻度认知障碍患者预立医疗照护计划研究进展及启示
邓蓓, 艾亚婷, 胡慧, 周常青, 杨怡, 彭云巧
- 湖北中医药大学,湖北 武汉 430065
摘要： 目的 概述轻度认知障碍群体开展预立医疗照护计划的研究进展,为我国轻度认知障碍群体开展本土化预立医疗照护计划提供参考。方法 回顾国内外相关文献,对轻度认知障碍患者预立医疗照护计划的实施现状、影响因素进行概述,并提出我国轻度认知障碍群体预立医疗照护计划的实施策略。结果 轻度认知障碍患者预立医疗照护计划的实施率较低,干预研究较少;轻度认知障碍患者预立医疗照护计划的开展主要与疾病、传统观念、患者、家庭及社会因素有关;轻度认知障碍老年群体的社区管理模式为预立医疗照护计划的开展提供了良好平台,提出了针对轻度认知障碍群体“以社区为管理,患者为中心,家庭为导向”的预立医疗照护计划策略。结论 轻度认知障碍患者可以作为我国本土预立医疗照护计划开展的第一梯队推广人群,建议将轻度认知障碍患者预立医疗照护计划的讨论契合患者的社区认知管理内容,未来仍需进一步开展相关应用研究。
中图分类号:
- R473.74
| [1] Sudore RL, Lum HD, You JJ, et al. Defining Advance Care Planning for Adults: A Consensus Definition from a Multidisciplinary Delphi Panel[J]. J Pain Symptom Manage,2017,53(5):821-832.e1. DOI:10.1016/j.jpainsymman.2016.12.331. [2] 邓仁丽,王守碧,张江辉,等.中西文化视野下预立医疗照护计划在医疗卫生体系中的植入[J].中国护理管理,2019,19(3):321-325. DOI: 10.3969/j.issn.1672-1756.2019.03.001. [3] Rietjens JAC, Sudore RL, Connolly M, et al.Definition and Recommendations for Advance Care Planning: An International Consensus Supported by the European Association for Palliative Care[J]. Lancet Oncol,2017, 18(9):e543-e551. DOI:10.1016/S1470-2045(17)30582-X. [4] 粟翠,庄碧嗓,李春韦,等.重症监护病房预立医疗照护计划研究进展[J].护理研究,2022,36(4):674-678.DOI:10.12102/j.issn.1009-6493.2022.04.020. [5] Cai S, Wang X, Wang R, et al.Clinicians’ Practices and Attitudes Regarding Advance Care Planning in Mainland China: A Multicenter Cross-sectional Survey[J]. Palliat Support Care,2022:1-6. DOI:10.1017/S1478951522000177 [6] 邢冰玉,缪群芳,章锦升,等.社区视角下国内外预立医疗照护计划的研究现状[J].中国全科医学,2021,24(34):4324-4329. DOI:10.12114/j.issn.1007-9572.2021.00.216. [7] 朱婷婷,陈长英,史岩,等. 预立医疗照护计划利益相关者评估工具的研究进展[J].中华护理杂志,2019,54(12):1800-1804. DOI:10.3761/j.issn.0254-1769.2019.12.007. [8] 陈柳柳,杨柳,赵俊延,等.护理人员预立医疗照护计划的沟通培训[J].护理学杂志,2020,35(10):47-50. DOI: 10.3870/j.issn.1001-4152.2020.10.047. [9] 孙叶,杨寅,王莹莹,等.老年痴呆症患者预立医疗照护计划的研究进展[J].护理学报,2021,28(2):24-27.DOI:10.16460/j.issn1008-9969.2021.02.024. [10] 朱懿珍,彭康琳,孟萌,等.预立医疗照护计划在阿尔茨海默病患者中的研究进展[J].中国护理管理,2021,21(2):298-302.DOI: 10.3969/j.issn.1672-1756.2021.02.028. [11] Mataqi M, Aslanpour Z.Factors Influencing Palliative Care in Advanced Dementia: A Systematic Review[J].BMJ Support Palliat Care, 2020,10(2):145-156. [12] Piers R, Albers G, Gilissen J, et al.Advance care Planning in Dementia: Recommendations for Healthcare Professionals[J]. BMC Palliat Care, 2018,17(1):88. DOI:10.1186/s12904-018-0332-2. [13] Tetrault A, Nyback MH, Vaartio-Rajalin H, et al.Advance Care Planning in Dementia Care: Wants, Beliefs, and Insight[J]. Nurs Ethics,2022,9697330211035498. DOI: 10.1177/09697330211035498 [14] O’Connor N, Fox S, Kernohan WG, et al. A Scoping Review of the Evidence for Community-based Dementia Palliative Care Services and Their Related Service Activities[J]. BMC Palliat Care,2022, 21(1):32. DOI:10.1186/s12904-022-00922-7. [15] Lingler JH, Hirschman KB, Garand L, et al.Frequency and Correlates of Advance Planning Among Cognitively Impaired Older Adults[J]. Am J Geriatr Psychiatry, 2008,16(8):643-649. DOI: 10.1097/JGP.0b013e31816b7324 [16] Garand L, Dew MA, Lingler JH, et al.Incidence and Predictors of Advance Care Planning Among Persons with Cognitive Impairment[J]. Am J Geriatr Psychiatry, 2011,19(8):712-720. DOI: 10.1097/JGP.0b013e3181faebef. [17] Gilissen J, Hunt L, Van den Block L, et al. Earlier Initiation of Palliative Care in the Disease Trajectory of People Living with Dementia: A Scoping Review Protocol[J]. BMJ Open, 2021, 11(6):e044502. DOI:10.1136/bmjopen-2020-044502. [18] Bosisio F, Jox RJ, Jones L, et al.Planning Ahead with Dementia: What Role Can Advance Care Planning Play? A Review on Opportunities and Challenges[J].Swiss Med Wkly,2018,148:w14706. DOI:10.4414/smw.2018.14706. [19] James T, Mukadam N, Sommerlad A, et al.Protection Against Discrimination in National Dementia Guideline Recommendations: A Systematic Review[J]. PLoS Med,2022,19(1):e1003860.DOI:10.1371/journal.pmed.1003860. [20] Harrison Dening K, Castle E, Scates C, De Vries K.Advance Care Plans in Dementia: User-centred Design[J]. BMJ Support Palliat Care,2020,10(4):e38.DOI:10.1136/bmjspcare-2018-001700. [21] Rose BL, Leung S, Gustin J, et al.Initiating Advance Care Planning in Primary Care: A Model for Success[J]. J Palliat Med,2019,22(4):427-431.DOI:10.1089/jpm.2018.0380. [22] Sinzlair C, Williams G, Knight A, et al.A Public Health Approach To Promoting Advance Care Planning To Aboriginal People in Regional Communities[J]. Aust J Rural Health, 2014,22(1): 23-28. DOI:10.1111/ajr.12079. [23] Bosisio F, Sterie AC, Rubli TE, et al.Implementing Advance Care Planning in Early Dementia Care:Results and Insights from a Pilot Interventional Trial[J]. BMC Geriatr,2021,21(1):573. DOI: 10.1186/s12877-021-02529-8. [24] Lewis M, Rand E, Mullaly E, et al.Uptake of a Newly Implemented Advance Care Planning Program in a Dementia Diagnostic Service[J]. Age Ageing,2015,44(6):1045-1049. DOI: 10.1093/ageing/afv138 [25] Cheong K, Fisher P, Goh J, et al.Advance Care Planning in People with Early Cognitive Impairment[J]. BMJ Support Palliat Care,2015,5(1):63-69. DOI:10.1136/bmjspcare-2014-000648. [26] Buck K, Nolte L, Sellars M, et al.Advance Care Directive Prevalence Among Older Australians and Associations with Person-level Predictors and Quality Indicators[J]. Health Expect,2021,24(4):1312-1325. DOI:10.1111/hex.13264. [27] Anderson BK, Mihilli S, Kumaresh M, etal. Advance Care Planning for Seniors Diagnosed with Dementia: A Scoping Review of the Canadian Literature[J]. Can J Aging,2022:1-27. DOI:10.1017/S0714980821000283. [28] Robinson L, Dickinson C, Rousseau N, et al.A Systematic Review of the Effectiveness of Advance Care Planning Interventions for People with Cognitive Impairment and Dementia[J]. Age Ageing,2012,41(2):263-269. DOI:10.1093/ageing/afr148. [29] Huang HL,Shyu YL, Weng LC, et al.Predictors of Advance Directives Among Nursing Home Residents with Dementia[J]. Int Psychogeriatr,2018,30(3):341-353. DOI: 10.1017/S1041610217001661. [30] 邓仁丽,陈柳柳,史宝欣,等.中国文化背景下预立医疗照护计划的研究进展[J].中华护理杂志,2015, 50(9):1117-1121. DOI: 10.3761/j.issn.0254-1769.2015.09.021. [31] Huang HL, Lu WR, Liu CL, et al.Advance care Planning Information Intervention for Persons with Mild Dementia and Their Family Caregivers: Impact on End-of-life Care Decision Conflicts[J]. PLoS One,2020,15(10):e0240684. DOI:10.1371/journal.pone.0240684. [32] 王守碧,张江辉,陈柳柳,等.轻度认知障碍老人参与预立医疗照护计划影响因素的质性研究[J].护理研究,2020,34(1):24-27.DOI:10.12102/j. issn.1009-6493.2020.01.004. [33] 中国痴呆与认知障碍诊治指南写作组,杜怡峰,吕佩源,等.2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J].中华医学杂志,2018,98(17):1294-1301.DOI: 10. 3760/cma.j.issn.0376-2491.2018.17.003. [34] 石义容,胡慧,王凌,等.社区老年轻度认知损害病人知-信-行现状调查及其影响因素[J].护理研究,2018,32(18):2857-2862. DOI: 10.12102/j.issn.1009-6493.2018.18.011. [35] Lo TJ, Ha NH, Ng CJ, et al.Unmarried Patients with Early Cognitive Impairment Are More Likely than Their Married Counterparts to Complete Advance Care Plans[J]. Int Psychogeriatr,2017,29(3):509-516.DOI:10.1017/S1041610216001903. [36] Ling M, Wang X, Ma Y, et al.A Review of the Current State of Hospice Care in China[J]. Curr Oncol Rep,2020,22(10):99. DOI:10.1007/s11912-020-00959-y. [37] Zhao SX, Qiang WM, Zheng XN, et al.Development of Death Education Training Content for Adult Cancer Patients: A Mixed Methods Study[J]. J Clin Nurs, 2018,27(23-24):4400-4410. DOI:10.1111/jocn.14595. [38] 谌永毅,成琴琴,王英,等.护理人员预立医疗照护计划知信行现状及对策分析[J].中国护理管理, 2019,19(3):334-340. DOI: 10.3969/j.issn.1672-1756.2019.03.004. [39] 中共中央国务院.“健康中国2030”规划纲要.The State Council of the Central Committee of the Communist Party of China[J]. Plan summary of health China,2030. 2016-10-25. [40] Sánchez-Sánchez E, Ruano-Álvarez MA, et al. Enteral Nutrition by Nasogastric Tube in Adult Patients under Palliative Care: A Systematic Review[J]. Nutrients, 2021,13(5):1562. DOI: 10.3390/nu13051562 [41] Biondo PD,Lee LD,Davison SN,et al.How Healthcare Systems Evaluate Their Advance Care Planning Initiatives: Results from a Systematic Review[J].Palliative Medicine,2016,30(8):720-729. DOI:10.1177/0269216316630883. [42] 艾亚婷,胡慧.社区老年人认知障碍筛查推荐建议[J].中国全科医学,2020,23(27):3375-3381. DOI: 10.12114/j.issn.1007-9572.2020.00.425. [43] 李子芬,彭楚君.推动“以家庭为中心”的预立医疗照护计划[J].中国护理管理,2019,19(3):326-329.DOI: 10.3969/j.issn.1672-1756.2019.03.002. [44] Daddato AE, Staton EW, Bettcher BM, et al.Human-centered Design of an Advance Care Planning Group Visit for Mild Cognitive Impairment[J]. Gerontologist,2021,23:181. DOI:10.1093/geront/gnab181. [45] Reidy J, Halvorson J, Makowski S, et al.Health System Advance Care Planning Culture Change for High-risk Patients: The Promise and Challenges of Engaging Providers, Patients, and Families in Systematic Advance Care Planning[J]. J Palliat Med,2017,20(4):388-394. DOI:10.1089/jpm.2016.0272. [46] Davies N, Schiowitz B, Rait G, et al.Decision Aids to Support Decision-making in Dementia Care: A Systematic Review[J]. Int Psychogeriatr, 2019, 31(10):1403-1419. DOI:10.1017/S1041610219000826. [47] Kotwal AA, Barnes DE, Volow AM, et al.Engaging Diverse Older Adults with Cognitive Impairment and Caregivers in Advance Care Planning: A Pilot Study of the Interactive PREPARE Website[J]. Alzheimer Dis Assoc Disord,2021,35(4):342-349. DOI:10.1097/WAD.0000000000000465. |
| [1] | 蒲丛珊, 王义婷, 丁磊, 单春剑, 朱珠. 孕产妇分娩恐惧测评工具的研究进展[J]. 护理学报, 2022, 29(1): 30-34. |
| [2] | 杨丽潇, 周春兰, 叶孝灵, 王润. 国内外老年人健康需求评估工具的研究现状及启示[J]. 护理学报, 2021, 28(21): 36-40. |
| [3] | 孙叶, 杨寅, 王莹莹, 王天沛. 老年痴呆症患者预立医疗照护计划的研究进展[J]. 护理学报, 2021, 28(2): 24-27. |
| [4] | 刘敏利, 周春兰, 龙艳娟, 肖秀英, 黄玉楼, 黄小娜, 李小贞, 龚秀群, 李苏城, 黄锦航, 彭小平, 耿丽, 梁美燕. 珠海市金湾区老年人轻度认知障碍现况调查及影响因素分析[J]. 护理学报, 2021, 28(13): 74-78. |
| [5] | 王恬, 陆海英. 国内外灾害护理管理模式的研究进展及思考[J]. 护理学报, 2020, 27(23): 28-31. |
| [6] | 江丹丹, 陈红宇, 胡君娥. 心理痛苦筛查工具在肺癌患者中的应用研究进展[J]. 护理学报, 2019, 26(7): 25-27. |
| [7] | 卞薇, 苏君, 郭文梅, 万君丽, 谭明琼, 王丽华. 医患共同决策测评工具的研究进展[J]. 护理学报, 2019, 26(7): 28-33. |
| [8] | 谢淑萍, 杨希, 杨璨, 叶丽娟, 顾玉炎, 叶巧玲, 章敏, 吴婉英. 预立医疗照护计划的发展现状与前景分析[J]. 护理学报, 2019, 26(22): 19-22. |
| [9] | 程蕾, 连冬梅. 慢性病儿童疲乏评估工具的研究进展[J]. 护理学报, 2019, 26(2): 30-33. |
| [10] | 田丽, 李梦媛, 李佳倩, 朱冰洁, 张青月, 阎玲. COPD患者预立医疗照护计划的研究进展[J]. 护理学报, 2019, 26(17): 22-26. |
| [11] | 张鲁敏, 顾芬. 叙事护理在健康教育中的应用研究进展[J]. 护理学报, 2019, 26(1): 28-31. |
| [12] | 赵延慧,唐楠,韩琳,王艳红,张宏晨. 国内外日间手术患者延续性护理研究进展[J]. 护理学报, 2018, 25(6): 24-27. |
| [13] | 卞薇,谭明琼,温健琳,苏君. 在线患者社会网络在慢性病患者健康行为促进领域中的应用研究进展[J]. 护理学报, 2018, 25(3): 37-41. |
| [14] | 明星,王志红. 国内外关于激素分泌与睡眠较少导致肥胖或超重关系的研究进展[J]. 护理学报, 2018, 25(18): 45-48. |
| [15] | 张田岳,张振香. 英国临床研究护士发展现状及对我国的启示[J]. 护理学报, 2018, 25(16): 56-59. |
|