The Effectiveness of Advance Care Planning Training for Care Home Staff: a Systematic Review
Notice bibliographique
Résumé
Abstract In line with population ageing, the number of global deaths is predicted to increase. There have been projections that, within the next 20 years, in England and Wales, care homes may become the most common place of death. In order to respect the autonomy of their residents, it is therefore, vital that care home staff are able to have Advance Care Planning conversations. However, care home staff may lack the knowledge or confidence to have such discussions. Further, a systematic review found a paucity of evidence about whether Advance Care Planning training interventions for care home staff are effective. New, higher quality studies are now available, justifying this review update. We sought to address two questions: 1) ‘What Advance Care Planning education interventions exist for care home staff?’ and 2) ‘how effective are these interventions?’ All measurable outcomes of effectiveness (e.g. health system/resource-related, patient/relative-related, staff-related) including both qualitative and quantitative measures of effectiveness were considered. Design The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) and is registered on PROSPERO (ID: CRD42022337865). Original research evaluating Advance Care Planning education for care home staff and reporting any measurable outcome of effectiveness was included. We searched Ovid Medline All, Ovid Embase, Cochrane Central Register of Controlled Trials, EBSCO CINAHL, EBSCO ERIC, and Ovid PsycINFO from March 2018 (3 months prior to original review search cut-off) to June 2022, with supplemental journal and website searches. The results were synthesised by narrative synthesis. Findings The current review update almost doubled the number of included studies in a relatively short period. This review includes 10 studies (n = 310 care homes), from the UK, Belgium, Norway and Canada. UK studies were mainly related to the Gold Standard Framework for Care Homes. Two studies adopted multi-component education interventions. Outcome measures included resident/family, staff and health service-related concepts. Even after identifying a further 5 papers, there remains insufficient evidence to determine the effectiveness of Advance Care Planning education interventions for care home staff. Conclusions Advance Care Planning education interventions are heterogeneous and often complex in their design, flexibility, target populations, and outcomes. There remains insufficient data to determine the effectiveness of Advance Care Planning education interventions for care home staff, with a particularly urgent need to agree on outcome measures of the effectiveness. Future research could consider updating the existing Delphi consensus on outcome measures for evaluating Advance Care Planning, in light of this systematically collected evidence, with a view to agreeing outcomes that are specific to Advance Care Planning education interventions for care home staff.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,073 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,012 | 0,010 |
| Bibliométrie | 0,006 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».