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使指南与医疗实践相一致:儿科姑息治疗指南的文献综述

Aligning guidelines and medical practice: Literature review on pediatric palliative care guidelines.

作者信息

De Clercq Eva, Rost Michael, Pacurari Nadia, Elger Bernice S, Wangmo Tenzin

机构信息

Institute for Biomedical Ethics,University of Basel,Basel,Switzerland.

出版信息

Palliat Support Care. 2017 Aug;15(4):474-489. doi: 10.1017/S1478951516000882. Epub 2017 Jan 9.

Abstract

OBJECTIVE

Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines.

METHOD

To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL. No restrictions were placed on the type of methodology employed in the studies.

RESULTS

Concerning barriers, most of the papers focused on gaps within medical practice and the lack of evidence-based research. Common recommendations therefore included: training and education of healthcare staff, formation of a multidisciplinary PPC team, research on the benefits of PPC, and raising awareness about PPC. A small number of publications reported on the absence of clear guidance in PPC documents regarding bereavement care, as well as on the difficulties and challenges involved in multidisciplinary care teams.

SIGNIFICANCE OF RESULTS

Our results indicate that a critical assessment of both the research guidelines and medical practice is required in order to promote timely implementation of PPC for pediatric patients.

摘要

目的

儿童姑息治疗正成为医疗保健领域一个重要的亚专业。尽管建议同时进行治愈性治疗和姑息治疗,但及时转诊至儿童姑息治疗(PPC)服务仍存在问题。本综述旨在透过PPC指南审视儿童姑息治疗正确实施的障碍与建议。

方法

为识别有关PPC指南的研究,于1960年至2015年间系统检索了五个数据库:Scopus、PubMed、PsycINFO、科学网和护理学与健康领域数据库。对研究中采用的方法类型未作限制。

结果

关于障碍,大多数论文关注医疗实践中的差距以及循证研究的缺乏。因此常见的建议包括:对医护人员进行培训和教育、组建多学科PPC团队、研究PPC的益处以及提高对PPC的认识。少数出版物报道了PPC文件中关于哀伤护理缺乏明确指导,以及多学科护理团队所涉及的困难与挑战。

结果的意义

我们的结果表明,为促进对儿科患者及时实施PPC,需要对研究指南和医疗实践进行批判性评估。

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