Experience and perceptions of healthcare professionals on using mortality prognostic tools on older people: A systematic review and meta aggregation of qualitative findings.
TL;DR
The need for understanding how older people and their family members would accept using mortality prognostic tools during end-of-life care to initiate effective person-and family-centred care approaches is highlighted.
Abstract
Mortality Prognostic Tools (MPTs) provide valuable insights when preparing for end-of-life care by enabling the early detection of mortality risk. However, little is known about how Healthcare Professionals (HPs) perceive and experience the use of such tools in practice. This review aimed to synthesise qualitative evidence on HPs' experiences and perceptions of the use of MPTs for older people. A qualitative meta-aggregation was performed following the Joanna Briggs Institute (JBI) methodology for qualitative evidence. Five electronic databases were searched. Eight studies out of 10,849 met the inclusion criteria for synthesis. The findings were grouped into 13 categories, resulting in five synthesised findings (Openness to MPTs, Practical utility of the tools in end-of-life care planning, Perceived barriers and limitations of the MPTs, Staff preparedness for utilising tools and Limitations of tool development) that highlighted the importance of enhancing prognostic confidence and effective prognostic communication among HPs. They further viewed these tools as useful prompts for supporting clinical decision-making when integrated into routine workflows. However, prognostic uncertainty, time constraints, emotional burden, and lack of training constrained their consistent use. The review highlights the need for understanding how older people and their family members would accept using mortality prognostic tools during end-of-life care to initiate effective person-and family-centred care approaches.