1. Objectifs

Intentions :
«This integrative review aims to analyse published articles on the experience of surrogates who find themselves making end‐of‐life decisions for a relative with a NCD [neurocognitive disorder] in a nursing home.» (p. 3)

2. Méthode

Échantillon/Matériau :
«The literature search was conducted between May and June 2017. […] The CINAHL, PubMed, PsycInfo, Embase and Web of Science databases were searched […]. [The authors] also performed a complementary citation pearl search and manually verified the reference lists from the selected articles. The articles had to be in English or French and published in 2005 or later.» (p. 3) «To be included, the articles had to specifically address surrogates making end‐of‐life decisions for someone with a NCD in a nursing home.» (p. 4) «A total of 18 articles were retained: 11 qualitative, 5 quantitative and 1 mixed method study, as well as 1 ethical argument.» (p. 4)

Type de traitement des données :
Réflexion critique

3. Résumé

«This integrative review shows that the decision‐making process guiding the end of life of people with a NCD is influenced by various aspects, particularly ethical considerations. Surrogates see their role in this process as ambiguous, and their desired degree of involvement varies greatly. Health professionals and extended families are central actors in supporting surrogates in the decision‐making process; the quality of life of the person with a NCD, as perceived by the surrogates, is also an important influencing factor.» (p. 8) According to the authors, «few studies have examined the surrogates’ fear of abandoning their relative when applying palliative or end‐of‐life care. This issue was mentioned spontaneously by a few surrogates in some of the studies and thus presents a low level of evidence. Yet, these affirmations would lead us to think that these fears could significantly influence the decision‐making process and therefore deserve further attention in future studies. The fear that a loved one will be abandoned, neglected or will not receive proper or good‐quality care could cause families to decide against palliative care even when it is justified.» (p. 9)