Evidenzlage zu Advance Care Planning bei Menschen mit Demenz – Ein systematisches Review (2017–2023)

Zusammenfassung

Hintergrund

Für Menschen mit Demenz ist eine frühzeitige Auseinandersetzung mit Themen der Versorgungsplanung von zentraler Bedeutung. Das Konzept des Advance Care Planning (ACP) bietet eine vielversprechende Möglichkeit ihre individuellen Wünsche in Hinblick auf Pflege und Behandlung am Lebensende zu berücksichtigen. Ziel Ziel dieser Arbeit ist es eine Übersicht zur aktuellen Evidenzlage zum Thema Advance Care Planning bei Menschen mit Demenz bereitzustellen.

Methodik

Es wurde eine systematische Literaturrecherche in den internationalen Datenbanken Medline, PsycINFO, Scopus, CINAHL und CENTRAL für den Zeitraum von Januar 2017 bis April 2023 durchgeführt. Die Studienqualität der eingeschlossenen Studien wurde mittels Critical Appraisal Skills Programme (CASP) bewertet.

Ergebnisse

Sieben Studien konnten in der qualitativen Analyse berücksichtigt werden. Die Studien zeigen positive Effekte des Advance Care Planning auf unterschiedliche Domänen für Menschen mit Demenz und ihre Pflegenden. Die eingeschlossenen RCTs weisen allerdings große Heterogenität hinsichtlich Methodik, Qualität und ihrer erhobenen Endpunkte auf.

Schlussfolgrung

Videos und Schulungen können ein wirksames Instrument sein, um ACP für Menschen mit Demenz und ihre Pflegenden erfolgreich zu implementieren. Allerdings sind Studien mit strengen Interventionskriterien und einheitlichen Endpunkten erforderlich, um die Wirksamkeit zu Advance Care Planning abschließend beurteilen zu können.

Abstract

Background

Early involvement in care planning is essential for people with dementia. The concept of advance care planning (ACP) offers a promising opportunity to consider their individual wishes for care and treatment at the end of life. Aim The aim of this review was to provide an overview of the current evidence on advance care planning for people with dementia.

Methods

We conducted a systematic literature search in the databases Medline, PsycINFO, Scopus, CINAHL, and CENTRAL for articles published between January 2017 and April 2023. The study quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP).

Results

Seven studies were included in the qualitative analysis. The studies demonstrated positive effects of Advance Care Planning on various domains for individuals with dementia and their caregivers. However, the included RCTs exhibited significant heterogeneity in terms of methodology, quality, and measured outcomes.

Conclusion

Videos and training can be effective tools for successfully implementing ACP for individuals with dementia and their caregivers. However, studies with stringent intervention criteria and standardized outcomes are needed to conclusively assess the effectiveness of Advance Care Planning.

Schlüsselwörter

Demenz - Advance Care Planning - Vorausschauende Versorgungsplanung - pflegende Angehörige

Keywords

dementia - Advance Care Planning - advance directive - caregiver

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