Kiwanuka Frank, Shayan Shah Jahan, Tolulope Agbele Alaba
International Campus Tehran University of Medical Sciences Tehran Iran.
School of Nursing Kabul University of Medical Sciences Kabol Afghanistan.
Nurs Open. 2019 Mar 28;6(3):676-684. doi: 10.1002/nop2.253. eCollection 2019 Jul.
Despite remarkable theoretical evidence of positive outcomes of patient and family-centred care, it is rarely performed in the intensive care setting. The aim of this review was to assess the barriers to patient and family-centred care among healthcare providers, patients and family members in adult intensive care units.
A systematic review of both qualitative and quantitative studies.
The search strategy sought for published peer-reviewed research papers limited to English language from conception to 2018. The review protocol was registered in the CRD Prospero database (CRD42018086838). Literature search was carried out in four databases: EMBASE, Cochrane Library, PubMed and Scopus where keywords "barriers," "patient and family centered care," "patient-centered care" and "intensive care unit" appeared in any part of the reference. Hand search of reference lists of identified papers was also done to capture all pertinent materials. Each study was assessed by three independent reviewers against the inclusion criteria. Evidence was graded according to sampling quality, quantity and measurement of intended outcomes. Screening of studies and citations resulted in seven studies that were included in the analysis.
Barriers to patient and family-centred care broadly fall under four categories; lack of understanding of what is needed to achieve patient and family-centred care, organizational barriers, individual barriers and interdisciplinary barriers.
尽管有显著的理论证据表明以患者和家庭为中心的护理能带来积极结果，但在重症监护环境中却很少实施。本综述的目的是评估成人重症监护病房中医护人员、患者及家属在以患者和家庭为中心的护理方面存在的障碍。
对定性和定量研究进行系统综述。
检索策略为查找从创刊至2018年发表的仅限英文的同行评审研究论文。综述方案已在CRD Prospero数据库（CRD42018086838）中注册。在四个数据库中进行文献检索：EMBASE、Cochrane图书馆、PubMed和Scopus，检索词“障碍”、“以患者和家庭为中心的护理”、“以患者为中心的护理”和“重症监护病房”出现在参考文献的任何部分。还对手检已识别论文的参考文献列表以获取所有相关材料。每项研究由三名独立评审员根据纳入标准进行评估。根据抽样质量、数量和预期结果的测量对证据进行分级。对研究和引文的筛选产生了七项纳入分析的研究。
以患者和家庭为中心的护理障碍大致可分为四类；对实现以患者和家庭为中心的护理所需条件缺乏理解、组织障碍、个人障碍和跨学科障碍。
