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Advance care planning, palliative care, and end-of-life care interventions for homeless people: A systematic review.
- Source :
- Palliative Medicine; Feb2017, Vol. 31 Issue 2, p109-119, 11p, 1 Diagram, 3 Charts
- Publication Year :
- 2017
-
Abstract
- Background: Homeless individuals have a high prevalence of multiple chronic comorbidities and early mortality compared to the general population. They also experience significant barriers to access and stigmatization in the healthcare system. Providing advance care planning, palliative care, and end-of-life care for this underserved population is an important health issue. Aim: To summarize and evaluate the evidence surrounding advance care planning, palliative care, and end-of-life care interventions for homeless persons. Design: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources: Articles from MEDLINE, EMBASE, CINAHL, PsycINFO, Social Work Abstracts, Cochrane Library, Web of Science, and PubMed databases were searched through 13 June 2015. Peer-reviewed studies that implemented advance care planning, palliative care, and end-of-life care interventions for homeless populations were included. Data from studies were independently extracted by two investigators using pre-specified criteria, and quality was assessed using modified Cochrane and Critical Appraisal Skills Programme tools. Results: Six articles met inclusion criteria. Two studies were randomized controlled trials involving advance directive completion. Two cohort studies investigated the costs of a shelter-based palliative care intervention and predictors for completing advance directives. These studies were rated low to fair quality. Two qualitative studies explored the interface between harm-reduction services and end-of-life care and the conditions for providing palliative care for homeless persons in a support home. Conclusion: The effectiveness of advance care planning, palliative care, and end-of-life care interventions for homeless individuals is uncertain. High-quality studies of interventions that reflect the unique and complex circumstances of homeless populations and investigate patient-related outcomes, caregiver burden, and cost-effectiveness are needed. [ABSTRACT FROM AUTHOR]
- Subjects :
- PSYCHIATRIC diagnosis
SEXUALLY transmitted disease diagnosis
TUBERCULOSIS diagnosis
COMPETENCY assessment (Law)
GOVERNMENT agencies
CHRONIC diseases
CINAHL database
CONFIDENCE intervals
HEALTH services accessibility
HEPATITIS
HIV infections
HOMELESS persons
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
MEDICAL care
MEDICAL protocols
MEDLINE
META-analysis
PALLIATIVE treatment
PROFESSIONAL peer review
QUALITY assurance
REPORT writing
SUPPORT groups
SOCIAL stigma
SUBSTANCE abuse
TERMINALLY ill
ADVANCE directives (Medical care)
COMORBIDITY
LITERATURE reviews
CRISIS intervention (Mental health services)
RANDOMIZED controlled trials
ACQUISITION of data
Subjects
Details
- Language :
- English
- ISSN :
- 02692163
- Volume :
- 31
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 120960645
- Full Text :
- https://doi.org/10.1177/0269216316649334