患者、家属和医疗团队是否从烧伤重症监护病房的姑息治疗整合中受益?系统评价与叙述性综合的结果。
Do patients, families, and healthcare teams benefit from the integration of palliative care in burn intensive care units? Results from a systematic review with narrative synthesis.
机构信息
Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal.
出版信息
Palliat Med. 2019 Dec;33(10):1241-1254. doi: 10.1177/0269216319862160. Epub 2019 Jul 12.
BACKGROUND
Burn units are intensive care facilities specialized in the treatment of patients with severe burns. As burn injuries have a major impact in physical, psychosocial, and spiritual health, palliative care can be a strengthening component of integrated care.
AIM
To review and appraise the existing evidence about the integration of palliative care in burn intensive care units with respect to (1) the concept, model and design and (2) the benefits and outcomes of this integration.
DESIGN
A systematic review was conducted following PRISMA guidelines. Protocol registered with PROSPERO (CRD42018111676).
DATA SOURCES
Five electronic databases were searched (PubMed/NLM, Web of Science, MEDLINE/TR, Ovid, and CINAHL/EBSCO) until May 2019. A narrative synthesis of the findings was constructed. Hawker et al.'s tool was used for quality appraisal.
RESULTS
A total of 299 articles were identified, of which five were included for analysis involving a total of 7353 individuals. Findings suggest that there may be benefits from integrating palliative care in burn units, specifically in terms of patients' comfort, decision-making processes, and family care. Multidisciplinary teams may experience lower levels of burden as result of integrating palliative care in burn units.
CONCLUSION
This review reflects the challenging setting of burn intensive care units. Evidence from these articles suggests that the integration of palliative care in burn intensive care units improves patients' comfort, decision-making process, and family care. Further research is needed to better understand how the integration of palliative care in burn intensive care units may be fostered and to identify the outcomes of this integration.
背景
烧伤病房是专门治疗严重烧伤患者的重症监护病房。由于烧伤对身体、心理社会和精神健康有重大影响,姑息治疗可以成为综合治疗的一个强化组成部分。
目的
回顾和评估姑息治疗在烧伤重症监护病房中的整合情况,具体涉及(1)概念、模式和设计,以及(2)这种整合的益处和结果。
设计
按照 PRISMA 指南进行系统评价。方案在 PROSPERO(CRD42018111676)注册。
资料来源
五个电子数据库(PubMed/NLM、Web of Science、MEDLINE/TR、Ovid 和 CINAHL/EBSCO)进行了搜索,截至 2019 年 5 月。对研究结果进行了叙述性综合。采用 Hawker 等人的工具进行质量评估。
结果
共确定了 299 篇文章,其中 5 篇被纳入分析,共涉及 7353 人。研究结果表明,姑息治疗在烧伤病房的整合可能会带来益处,特别是在患者的舒适度、决策过程和家庭护理方面。多学科团队可能会因将姑息治疗整合到烧伤病房而减轻负担。
结论
这篇综述反映了烧伤重症监护病房的挑战性环境。这些文章的证据表明,姑息治疗在烧伤重症监护病房的整合可以提高患者的舒适度、决策过程和家庭护理。需要进一步研究以更好地了解如何促进姑息治疗在烧伤重症监护病房的整合,并确定这种整合的结果。