Abstract: Objective: To analyze and evaluate the barriers of nurses' participation in end-of-life decision-making for patients in the end-stage, so as to provide a reference for improving end-of-life decision-making mode. Methods: PubMed, Web of Science, PsycINFO, The Cochrane Library, Embase, Medline, CBM, CNKI, Wanfang and VIP databases were searched for qualitative studies on the influencing factors of nurses' participation in patients' end-of-life decision-making from the establishment of the database to September 2022. The quality of literature was evaluated by the qualitative research quality evaluation criteria of Australian JBI Evidence-based Health Care Center, and the results were integrated by the pooled integration method. Results: A total of 10 literatures were included, 26 research results were extracted, 7 categories were formed, and 3 integrated results, including end-of-life decision-making ability, cognition and attitude, medical environment were synthesized. Conclusion: There are many factors that prevent nurses from participating in end-of-life decision-making. It is suggested to adopt various decision-making in time, provide medical supports and humanistic care, help nurses improve their ability and confidence in decision-making, and provide a reliable basis for promoting the development of end-of-life service system in China.

Key words: nurse; terminally ill patient; end-of-life decision; obstacle; qualitative research; Meta-synthesis