1 Department of Nursing, College of Nursing, Seattle University, Seattle, Washington.
2 Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
J Palliat Med. 2019 Jul;22(7):848-857. doi: 10.1089/jpm.2018.0304. Epub 2019 Jan 11.
End-of-life (EOL) care in neonatal intensive care units (NICUs) can vary depending on religious beliefs of health care providers and families as well as the sociocultural environment. Although guidelines exist for EOL care in NICUs, most are based on Western studies, and little is known about such care in Asian countries, which have different religious and social background. This review synthesized empirical research to reveal the state of the science on infant EOL care in Asian countries. This was an integrative review. Data were collected from studies identified in CINAHL, Embase, PsycINFO, and PubMed. The search was limited to current empirical studies involving infant EOL care in Asian countries and published in English between 2007 and 2016. Of 286 studies initially identified, 11 empirical studies conducted in Hong Kong, India, Israel, Japan, Mongolia, Taiwan, and Turkey were included in the review. Four themes were captured: factors influencing decision making, trends in decision making, practical aspects of EOL care, and health care providers' preparation. In most NICUs, health care providers controlled decisions regarding use of life-sustaining treatment, with parents participating in decision making no more than 60% of the time. Although care decisions were gradually changing from "do everything" for patient survival to a more palliative approach, comfort care at the EOL was chosen no more than 63% of the time. While infant EOL care practice and research vary by country, few articles address these matters in Asia. This integrative review characterizes infant EOL care in Asia and explores cultural influences on such care.
新生儿重症监护病房（NICU）的临终关怀可能因医疗保健提供者和家庭的宗教信仰以及社会文化环境而异。尽管 NICU 临终关怀有指南，但大多数都是基于西方的研究，对于亚洲国家的临终关怀了解甚少，这些国家有不同的宗教和社会背景。本综述综合了实证研究，揭示了亚洲国家婴儿临终关怀的科学现状。这是一个综合回顾。数据来自 CINAHL、Embase、PsycINFO 和 PubMed 中确定的研究。搜索范围限于 2007 年至 2016 年期间在亚洲国家以英语发表的关于婴儿临终关怀的当前实证研究。在最初确定的 286 项研究中，有 11 项来自香港、印度、以色列、日本、蒙古、中国台湾和土耳其的实证研究被纳入综述。捕捉到四个主题：影响决策的因素、决策趋势、临终关怀的实际方面以及医疗保健提供者的准备。在大多数 NICU 中，医疗保健提供者控制着是否使用维持生命治疗的决策，而父母参与决策的时间不超过 60%。尽管护理决策正逐渐从“为患者生存做一切”转变为更姑息的方法，但临终关怀时选择舒适护理的时间不超过 63%。虽然婴儿临终关怀实践和研究因国家而异，但亚洲的文章很少涉及这些问题。本综述描述了亚洲的婴儿临终关怀，并探讨了文化对这种护理的影响。
