This scoping review methodology will be conducted following the latest guidelines by the Joanna Briggs Institute (JBI) [30] to explore the literature describing the EOLC with multiple interventions for people with COPD. In addition, the reporting process of this research will adhere to the preferred reporting items for systematic reviews and meta-analysis extension for scoping reviews (PRISMA-ScR) [31]. This study has been registered in the Open Science Framework (OSF) (https://osf.io/upd4a).
Stage 1. Identifying the Research Question
We will identify what is known from the existing literature about all aspects of EOLC with multiple interventions for people with COPD. Our scoping review will describe the following research questions:
1. What are the characteristics of the EOLC interventions that people with COPD receive at EOL?
2. What are the characteristics of the multidisciplinary professional practices of EOLC?
3. How is EOLC defined in the target literature?
4. How is decision-making in EOLC with multiple interventions for patients with COPD described in the selected literature?
5. What has been evaluated in EOLC from the perspective of each study?
Table 1
The PCC (participants/concept/context) Framework
Participants
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Chronic obstructive pulmonary disease
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Concept
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End-of-life care involving multiple interventions
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Context
|
End of life
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Table 2
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Inclusion Criteria
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Exclusion Criteria
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Participants
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λ Include people with chronic obstructive pulmonary disease (COPD)
λ Include adult population (age > 18)
λ People with COPD in EOLC trajectory
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λ People with under-diagnosed COPD
λ Adolescents (under 18 years of age)
λ Studies conducted on participants who were not at the end-of-life phase
λ Studies that include results regarding diseases other than chronic obstructive pulmonary disease
|
Concept
|
λ Including two or more different healthcare professionals (HCPs) treatments for people with COPD at the end-of-life care trajectory
λ End-of-life care that includes multiple interventions such as palliative care, supportive care, advance care planning, and spiritual care
|
λ Not including healthcare professionals
λ Single intervention
λ Palliative care provided merely to relieve/treat symptoms
|
Context
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λ End of life
λ Include any settings of study (i.e., medical facilities, community home health care, nursing home)
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λ Not related to end-of-life context
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Stage 2. Identifying Relevant Studies
The eligibility criteria in this scoping review are constructed based on the PCC (participants/concept/context) framework focused on EOLC involving multiple interventions for people with COPD (Table 1, 2).
Search Strategy
The search strategy was developed after identifying initial keywords and index terms relevant to the purpose and research questions of this study from previous research with advice from the librarian at St. Luke's International University. The initial simple search concepts were set out as "chronic obstructive pulmonary disease" and "end-of-life care". Furthermore, in this scoping review, we will adopt three search processes following the standard JBI systematic review approach. The first step is an initial limited search of Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL with Full Text, Embase, PsycINFO, and Google Scholar, followed by an analysis of the text words and keywords contained in the titles and abstracts of each of the initial literature sources. The second step will be a search of all relevant databases using the keywords and index terms obtained in the first step of the search with no restrictions on language, publication date, or publication type. Third, we will search for the reference list of all adopted papers and will identify additional literature. In addition, we will include all quantitative studies and qualitative studies of the after-year publication of each electronic database and comprehensively search to identify both published and unpublished literature (Table 3).
Table 3
#1
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("chronic obstructive pulmonary disease"[Title/Abstract] OR "pulmonary disease, chronic obstructive"[MeSH Terms] OR "COPD"[Title/Abstract])
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#2
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("Interdisciplinary"[Text Word] OR "multicomponent"[Text Word] OR "interprofessional"[Text Word] OR "transdisciplinary"[Text Word] OR "comprehensive"[Text Word] OR "integrated"[Text Word] OR "patient care team"[MeSH Terms] OR "interprofessional relations"[MeSH Terms] OR "comprehensive health care"[MeSH Terms] OR "delivery of health care, integrated"[MeSH Terms])
|
#3
|
("end of life care"[Title/Abstract] OR ("terminal care"[MeSH Terms] OR "hospice care"[MeSH Terms]) OR "supportive care"[Title/Abstract] OR "advance care planning"[Title/Abstract] OR "advance care planning"[MeSH Terms] OR "Advance Directives"[MeSH Terms] OR "shared decision making"[Title/Abstract] OR "decision making, shared"[MeSH Terms] OR "palliative care"[Title/Abstract] OR "palliative care"[MeSH Terms] OR "spirituality care"[Title/Abstract] OR "spiritual care"[Title/Abstract] OR "spiritual therapies"[MeSH Terms])
|
#4
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#1 AND #2 AND #3
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Stage 3. Study Selection
All searched articles will be managed using Rayyan software, and duplicate articles will be removed. Titles and abstracts will be screened carefully and irrelevant studies removed based on the eligibility criteria. After selecting potentially relevant studies, reviewers read the full text to make the final decision on inclusion in this review. All of the above processes of literature selection must be carried out independently by the main author (KM) and other reviewers (AM, CU). In case of any disagreement, it will be discussed with a third reviewer (TK). The details of the search decision process result which include the search, removal of duplicate citations, study selection, full retrieval, and additions from reference list searching will show the preferred reporting items for systematic reviews used and the meta-analysis (PRISMA) flow diagram (Fig. 1) [32].
Stage 4. Data Extraction
The data from the primary search of included reports will be extracted and charted using a data extraction form created by the main author following the research question and the eligibility criteria of this study [30]. In addition, the extraction and charting of the data process will be conducted independently by the main author. Afterward, cross-checking of extracted data will be administered with other reviewers (AM, CU), and when disagreements result regarding dissimilarities in terms of data extraction, they will be settled by the reviewers (CU, KM, TK).
The data extraction form is also available on Google Drive for data entry, data sharing, and management by reviewers. If not all the information is available in the articles, the main author will contact the original researcher via email to collect the information necessary for this scoping review.
The details of data from the included study in this review will be presented by adopting and using the collected data form by guidelines [30, 33, 34]. The outline of collecting data that will be extracted from quantitative and qualitative evidence is as follows: (a) the first author (s), (b) title, (c) year of publication, (d) country, (e) study location and setting, (f) aims of the study, (g) details of study methodology, (h) the theoretical background of the study, (i) data analysis approach, (j) date and duration of the study, (k) number of participants and their baseline data, (l) specific details and characteristics of the intervention, (m) details of usual care, (n) full range and timing of outcomes measured, (o) results, (p) adverse events, (q) suggestions made by the author (s), and (r) unreported data (Table 4).
Table 4
First author (s)
Title, year of publication
Country
Study location and setting
Aims of the study
Details of study methodology
Theoretical background of the study
Data analysis approach
Date and duration of the study
Number of participants and their baseline data
Specific details and characteristics of the intervention
Details of usual care
Full range and timing of outcomes measured
Key findings on end-of-life care that includes multiple interventions for people with chronic obstructive pulmonary disease
Adverse events
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Stage 5. Collating, Summarising, and Reporting the Results
This scoping review aims to explore the concept of EOLC with multiple interventions for people with COPD and the structures that underpin this concept. As with systematic reviews, this study will be based on explicit and systematic methods and will identify and review all types of available evidence from existing relevant qualitative and quantitative studies, collected without restriction on the type of literature. However, as the scoping review will not perform a typical quantitative synthesis of study data, it will not assess the methodological quality, heterogeneity, or risk of bias of the included studies. All results will be summarised using a narrative synthesis approach.
This scoping review will determine the research methods, study populations, intervention context and practice, evaluation methods, and key findings of the included studies. More importantly, this scoping review will identify from the details of these studies the key elements of comprehensive EOLC with multiple interventions for COPD patients. In addition, a comparison of the articles used in this review will identify the knowledge gaps in the evidence and potential biases [35].
The key conceptual categories will be presented in tables. However, due to the extensive and iterative nature of scoping reviews, the final presentation of data (e.g. using maps, charts, and tables) may be subject to change [30]. Therefore, if the need to revise how results are presented arises during the review, the most appropriate and reasonable way to present these results will be discussed among the researchers. The reasons for any changes will also be provided.