病房安宁疗护对终末期患者生活质量和情绪影响的Meta分析

Meta-Analysis of the Impact of Ward Palliative Care on the Quality of Life and Emotions of End-Stage Patients

摘要: 目的：系统评价病房安宁疗护对终末期患者生活质量和情绪的影响。方法：系统检索知网、万方、维普、Sino-Med、PubMed、ScienceDirect、Web of Science、The Cochrane Library等中英文数据库中关于病房安宁疗护对终末期患者生活质量和情绪影响的文章，检索时限为数据库建库至2024年6月。依据随机对照试验的偏倚分析评估工具(RoB2)评价文献质量，采用Review Manager 5.3软件进行Meta分析。结果：最终纳入文献8篇，共研究调查865名患者。Meta分析结果显示，病房安宁疗护能够提升终末期患者的生活质量[STD (95% CI) = 3.16 (1.60, 4.72), Z = 3.97, P < 0.01]和睡眠质量[MD (95% CI) = −3.74 (−4.41, −3.34), Z = 18.39, P < 0.01]；能减少终末期患者的不良心理状况：抑郁[STD (95% CI) = −4.32 (−6.34, −2.30), Z = 4.19, P < 0.01]和焦虑[STD (95% CI) = −3.12 (−4.60, −1.64), Z = 4.13, P < 0.01]。结论：病房安宁疗护能够提升终末期患者的生活质量和睡眠质量，减少终末期患者的不良心理状况(抑郁、焦虑)。

Abstract: Objective: To systematically evaluate the impact of hospice care in the ward on the quality of life and emotions of end-stage patients. Methods: A systematic search was conducted for articles in Chinese and English databases such as CNKI, Wan-Fang, VIP, Sino-Med, PubMed, ScienceDirect, Web of Science, The Cochrane Library, etc. regarding the impact of ward palliative care on the quality of life and emotions of end-stage patients. The search period is from database establishment to June 2024. According to the bias analysis evaluation tool (RoB2) for randomized controlled trials, literature quality was evaluated, and Meta-analysis was conducted using Review Manager 5.3 software. Results: Eight articles were ultimately included in the study, with a total of 865 patients surveyed. The Meta-analysis results showed that hospice care in the ward can improve the quality of life of end-stage patients [STD (95% CI) = 3.16 (1.60, 4.72), Z = 3.97, P < 0.01] and sleep quality [MD (95% CI) = −3.74 (−4.41, −3.34), Z = 18.39, P < 0.01]; and can reduce adverse psychological conditions in end-stage patients: depression [STD (95% CI) = −4.32 (−6.34, −2.30), Z = 4.19, P < 0.01] and anxiety [STD (95% CI) = −3.12 (−4.60, −1.64), Z = 4.13, P < 0.01]. Conclusion: Ward palliative can improve the quality of life and sleep for end-stage patients and can reduce the adverse psychological conditions (depression, anxiety) of end-stage patients.