关键词: 预前照护计划, 随机对照试验, Meta分析

Abstract: Objective: To systematically review the efficacy of advance care planning(ACP）interventions. Methods: The randomized controlled trials(RCT) on advance care planning were searched to collect from Cochrane Library, PubMed, EMbase, CBM, China National Knowledge Infrastructure(CNKI), and WANFANG database. After evaluated the quality of enrolled studies according to the inclusion and exclusion criteria, the meta-analysis was conducted with RevMan 5.3 software. Results: A total of 14 RCTs involving 4610 participants. The Meta-analysis showed that an increased likelihood for the completion of advance directives compared to usual care [OR=3.50，95%CI（1.89，6.51），P<0.01]; compared with the control group, the intervention group significantly improved patient-surrogate congruence[OR=3.58，95%CI（1.72，7.45），P=0.0007]; no significant difference in the decisional conflict between the intervention group and the control group [WMD= -0.02，95%CI（-0.15，0.11）, P=0.75]; an increased likelihood for the occurrence of acceptability on advance directives without psychosocial distress, but no evidence that ACP could improve cognitive status. Conclusion: ACP is effective to improve the completion of advance directives, the patient-surrogate congruence and the acceptability about advance directives, while the result of meta-analysis failed to support the effectiveness of ACP on decisional conflict and cognitive level. Large-scale and multi-centered randomized controlled trials are needed to confirm its effectiveness．

Key words: Advance care planning, Randomized controlled trials, Meta-analysis