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Advance care planning for people with dementia is an important process to ensure that patient preferences are respected throughout disease progression. However, the complexity of advance care planning and the challenges in effective communication hinder its implementation. The lack of clear procedural guidance for health care teams and the limited research on practical issues such as building trust and resolving conflicts further complicate this process.
To explore the key components of and processes for advance care planning for people with dementia.
The authors conducted a comprehensive search of databases, including PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, NICE, Open Grey, CNKI, and Wanfang. The inclusion criteria focused on studies reporting advance care planning practices and stakeholder perspectives related to dementia.
The review included 45 studies and identified key components and processes for successfully implementing advance care planning in dementia care. These components include enhancing readiness, capturing patient wishes, and executing those wishes. The implementation processes cover assessing participation capacity, selecting surrogate decision-makers, and identifying healthcare providers who implement advance care planning. As the condition of people with dementia progresses, the role of healthcare providers who implement advance care planning becomes increasingly important in advance care planning practices.
The success of advance care planning depends on the interconnection of multiple components, and the findings offer practical insights for improving the advance care planning process to ensure that the care preferences of people with dementia are respected throughout the progression of the disease.
PRISMA-ScR.
This is a review without patient and public contribution.
To explore the stability of resilience among frontline nurses and to analyse the predictive role of internal and external factors on the patterns of resilience transformation in China during public health emergencies.
The study used a longitudinal design and surveyed 258 frontline nurses at three different time points: February–March 2020 (T1), May–June 2020 (T2) and May–June 2022 (T3). The survey included the 10-item Connor–Davidson resilience scale, the Emotion Regulation Questionnaire and the Simple Coping Style Questionnaire. Latent profile analysis and latent transition analysis were used to examine the potential classes and changes. Multivariate logistic regression analysis was applied to evaluate the predictors of resilience transitions.
The resilience of frontline nurses was divided into three categories: fragile group, general group and high resilience group. From T1 to T2, the general group exhibited the least stability, with a probability of maintaining its original latent state at 72.9%. Marriage and positive coping styles significantly impacted the transition between resilience categories. From T2 to T3, the fragile group showed the lowest stability, with a 74.9% likelihood of retaining its initial latent state. In this context, supportive hospital management (including psychological counselling, restful environments, and both spiritual and material incentives) and individuals' emotional regulation and sleep quality significantly affected the transition between resilience categories.
These findings emphasise the necessity for early intervention. For frontline nurses, conducting initial assessments of resilience coupled with sustained hospital support is crucial for maintaining mental health and improving the quality of nursing care in public health emergencies.
This study offers a fresh perspective for understanding the resilience of frontline nurses during public health emergencies. At the same time, it reveals the factors that promote or hinder the change in resilience among frontline nurses at both individual and organisational levels. This provides a theoretical basis for future resilience interventions and helps us formulate effective crisis management strategies to respond to future public health emergencies. For frontline nurses with diverse resilience characteristics and relevant transformation factors, a personalised multi-mode resilience improvement plan can be developed to mitigate public health emergencies' potential adverse psychological impact on frontline nurses, especially those in the fragile group.
No patient or public contribution.
FreshRSS 