METHODS AND ANALYSIS: A systematic search will be conducted across nine electronic databases: PubMed, Scopus, EMBASE, Cochrane, PsycINFO, ERIC, CINAHL, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The search will identify literature published in English and Chinese from January 2012 onwards. Articles will be selected based on their relevance to older adults aged ≥60 with disabilities or life-threatening chronic conditions receiving end-of-life care in nursing homes or similar settings. The data extraction process will be guided by the Canadian Hospice Palliative Care Association model (CHPCA) and the Respectful Death model. Qualitative data analysis will be performed using a framework method and thematic analysis, employing both inductive and deductive approaches, with three reviewers participating in the review process.
ETHICS AND DISSEMINATION: Ethical approval is not required because the data for this review is obtained from selected publicly available articles. The results will be disseminated through publications in peer-reviewed journals and presented at relevant conferences. Furthermore, the findings will be shared with policymakers and healthcare professionals engaged in end-of-life care to inform practice and decision making.
STUDY REGISTRATION: The review protocol has been registered on osf.io (https://osf.io/3u4mp).
METHOD: Following the European QI protocol, auditing and data extraction of medical records of consenting residents with dementia were conducted by trained auditors with relevant health care backgrounds. Detailed field notes by the auditors were also obtained to describe the characteristics of the participating care facilities, as well as key issues and challenges encountered, for each of the 12 QIs.
RESULTS: Sixteen residential care facilities in the seven Asia-Pacific sites participated in this study. Data from 275 residents' records revealed each of the 12 Qis' endorsement varied widely within and between the study sites (0%-100%). Quality of the medical records, family and cultural differences, definitions and scoring of certain indicators, and time-consuming nature of the QI administration were main concerns for implementation.
CONCLUSION: Several items in the European QIs in the current format were deemed problematic when used to measure the quality of psychosocial care in the residential aged care settings in participating Asia-Pacific countries. We propose refinements of the European QIs for the Asian-Pacific context, taking into account multiple factors identified in this study. Our findings provide crucial insights for future research and implementation of psychosocial dementia care QIs in this region.