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撒哈拉以南非洲地区的儿科姑息治疗:对护理模式、干预措施及结果相关证据的系统评价

Pediatric palliative care in sub-saharan Africa: a systematic review of the evidence for care models, interventions, and outcomes.

作者信息

Harding Richard, Albertyn Rene, Sherr Lorraine, Gwyther Liz

机构信息

Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, United Kingdom.

Department of Paediatric Surgery, Red Cross Children's Hospital, Cape Town, South Africa.

出版信息

J Pain Symptom Manage. 2014 Mar;47(3):642-51. doi: 10.1016/j.jpainsymman.2013.04.010. Epub 2013 Aug 21.

Abstract

CONTEXT

The progressive disease burden among children in sub-Saharan Africa means the provision of palliative care is essential and should be provided alongside treatment where it is available.

OBJECTIVES

To systematically review the evidence for pediatric palliative care models, interventions, and outcomes to appraise the state of the science and inform best practice.

METHODS

A systematic review search strategy was implemented in eight electronic databases, the search results reported using a PRISMA statement, and findings tabulated.

RESULTS

In terms of evidence of palliative care provision and outcomes, only five articles were identified. These represent a small range of acute, community, and hospice care and offer some limited guidance on the development and delivery of services.

CONCLUSION

Pediatric palliative care is a pressing clinical and public health challenge in sub-Saharan Africa. Explicit evidence-based models of service development, patient assessment, and evidence for control of prevalent problems (physical, psychological, social, spiritual, and developmental) are urgently needed. Greater research activity is urgently required to ensure an evidence-based response to the enormous need for pediatric palliative care in sub-Saharan Africa.

摘要

背景

撒哈拉以南非洲儿童日益加重的疾病负担意味着提供姑息治疗至关重要,且在有条件的情况下应与治疗同时提供。

目的

系统回顾儿科姑息治疗模式、干预措施及结果的证据,以评估科学现状并为最佳实践提供依据。

方法

在八个电子数据库中实施系统回顾检索策略,使用PRISMA声明报告检索结果,并将研究结果制成表格。

结果

在姑息治疗提供情况及结果的证据方面,仅识别出五篇文章。这些文章涵盖了一小部分急性、社区和临终关怀护理,为服务的发展和提供提供了一些有限的指导。

结论

儿科姑息治疗是撒哈拉以南非洲紧迫的临床和公共卫生挑战。迫切需要基于明确证据的服务发展模式、患者评估以及控制常见问题(身体、心理、社会、精神和发育方面)的证据。迫切需要开展更多研究活动,以确保基于证据应对撒哈拉以南非洲对儿科姑息治疗的巨大需求。

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