老年人预立医疗照护计划准备度评估工具的系统评价

doi:10.3761/j.issn.0254-1769.2025.09.020

摘要/Abstract

摘要：

目的对适用于老年人的预立医疗照护计划准备度评估工具进行系统评价，为制订预立医疗照护计划提供可靠的评估工具。方法系统检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、医脉通、万方数据库、中国知网、维普数据库、中国生物医学文献数据库，检索时限为建库至2024年4月30日，筛选符合纳入标准的预立医疗照护计划准备度评估工具，采用“基于共识的健康测量工具选择标准”对纳入评估工具的方法学质量和测量学属性进行评价，采用改良版证据质量评价及推荐强度分级方法对评估工具进行证据分级，并形成最终的推荐意见。结果共纳入14篇文献，包含10个适用于老年人的预立医疗照护计划准备度评估工具，所有文献均未报告跨文化效度、测量误差和反应性。中文预立医疗照护计划准备度量表和慢性病患者预立医疗照护计划准备度量表的内容效度和内部一致性均为“充分”，为A级推荐，其余评估工具均为B级推荐。结论适用于老年人的预立医疗照护计划准备度评估工具种类多样，但方法学质量有待提高，测量学属性有待进一步评价。暂时推荐使用中文预立医疗照护计划准备度量表和慢性病患者预立医疗照护计划准备度量表。

关键词: 老年人, 预立医疗照护计划, 准备度, 评估工具, 系统评价, 护理

Abstract:

Objective To systematically evaluate the advance care planning readiness assessment tools applicable to the elderly and to provide a reliable assessment tool for the development of advance care planning. Methods PubMed，Web of Science，Cochrane Library，Embase，CINAHL，Yimaitong，Wanfang Database，China National Know-ledge Network，VIP Database，and China Biomedical Literature Database were systematically searched. The search time limit is from database establishment to April 30，2024. Pre-established medical care plan readiness assessment tools that meet the inclusion criteria were screened，and the “consensus based standards for the selection of health measurement instruments” was used to evaluate the methodological quality and measurement attributes of the inclusion assessment tools. The improved version of the evidence quality evaluation and recommendation strength grading method is used to grade the evidence of the assessment tool and form the final recommendation opinion. Results A total of 14 articles were included，including 10 advance care planning readiness assessment tools suitable for the elderly. None of the articles reported cross-cultural validity，measurement error，and responsiveness. The content validity and internal consistency of the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients were both “adequate”，with A-level recommendations，and the remaining assessment tools were all B-level recommendations. Conclusion There are various types of advance care planning readiness assessment tools for the elderly，but the methodological quality needs to be improved and the measurement properties need to be further evaluated. It is temporarily recommended to use the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients.

Key words: Aged, Advance Care Planning, Readiness, Evaluation Tools, Systematic Review, Nursing Care

彭颖洁, 刘艾红, 朱文莉, 梅雨欣, 周萌, 关文静. 老年人预立医疗照护计划准备度评估工具的系统评价[J]. 中华护理杂志, 2025, 60(9): 1146-1153.

PENG Yingjie, LIU Aihong, ZHU Wenli, MEI Yuxin, ZHOU Meng, GUAN Wenjing. Systematic review of readiness assessment tools for advance care planning in older adults[J]. Chinese Journal of Nursing, 2025, 60(9): 1146-1153.

图/表 4

图1 文献筛选流程

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征（n=14）

Table 1 General characteristics of the included literature（n=14）

表2 纳入评估工具的方法学质量和测量学属性评价结果（n=14）

Table 2 Evaluation of the methodological quality of the measurement properties of the included scales and studies（n=14）

表3 纳入评估工具测量学属性的总体评价与推荐意见（n=10）

Table 3 Evaluation of the psychometric properties and recommendations for inclusion in the assessment tools（n=10）

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