Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis

摘要: Background Breathlessness is a common, distressing symptom in people with advanced disease and marker of deterioration. Holistic services that draw on integrated palliative care have been developed for this group. This systematic review aimed to examine the outcomes, experiences therapeutic components these services. Methods Systematic searching nine databases June 2017 experimental, qualitative observational studies. Eligibility quality were independently assessed by two authors. Data service models, health cost outcomes synthesised, using meta-analyses as indicated. recipient synthesised thematically at level interpretation reporting. Results From 3239 records identified, 37 articles included representing 18 different Most enrolled thoracic cancer, involved staff comprised 4–6 contacts over weeks. Commonly used interventions breathing techniques, psychological support relaxation techniques. Meta-analyses demonstrated reductions Numeric Rating Scale distress due breathlessness (n=324; mean difference (MD) −2.30, 95% CI −4.43 −0.16, p=0.03) Hospital Anxiety Depression (HADS) depression scores (n=408, MD −1.67, −2.52 −0.81, p Conclusion chronic can reduce patients may improve anxiety depression. Therapeutic should be shared into clinical practice. Registration number CRD42017057508.