关键词: 慢性病, 终末期, 优逝, 期望, 需求, 质性研究, 系统评价, 安宁疗护

Abstract:

Objective To systematically review the expectation and needs of a good death in patients with end-stage chronic diseases. Methods We searched databases including PubMed,Embase,Web of Science,PsycINFO,Cochrane Library,CNKI,Wanfang,CBM from inception to March 2019. The Joanna Briggs Institute’s Critical Appraisal Tool for qualitative studies was used to evaluate the quality of included studies. The results were synthesized by integrating methods. Results A total of 14 studies were finally included,and 52 results were extracted,and then 4 synthesized results were summarized from the 10 categories. The integrated results were physiological needs（physiological needs at the end-stage,physiological needs at the time of death）,psychological needs（desire fulfillment,positive psychology）,spiritual needs（religious belief,maintenance of dignity,other spiritual needs）,and societal needs（interpersonal,economic,and support systems）. Conclusion The expectation and needs of a good death in patients with end-stage chronic disease involve physiological,psychological,spiritual and societal aspects,with characteristics of individuality and subjectivity,and through the whole process of end-stage. Different expectation and needs may overlap and influence each other. Healthcare providers should pay more attention to patients’ expectation and needs regarding a good death,and provide individualized nursing care for whole human and whole process,as well as spread the knowledge of good death to the public. It is crucial for social resources and health policy to improve the hospice care for those with end-stage chronic diseases.

Key words: Chronic Disease, End-stage, Good Death, Expectation, Need, Qualitative Research, Systematic Review, Hospice Care