Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.
College of Nursing, University of Manitoba, Winnipeg, MB, Canada.
J Clin Nurs. 2020 Feb;29(3-4):330-346. doi: 10.1111/jocn.15085. Epub 2019 Nov 21.
To synthesise and map the literature on the psychological outcomes reported following debriefing of healthcare providers who experience expected and unexpected patient death in either clinical practice or simulation setting.
Patient death occurs in both the clinical and simulation environments and can result in psychological stress in healthcare providers and students. While debriefing following patient death has demonstrated the ability to promote positive psychological outcomes, addressing the psychological or emotional stress of the event is inconsistently addressed.
A scoping review was conducted using the Arksey and O'Malley framework.
The Cochrane Library, MEDLINE, CINAHL, PsycINFO, JBI and Scopus databases were searched with English language constraints and no limit on publication date. The Scoping Reviews (PRISMA-ScR) Checklist was used (Annals of Internal Medicine, 2018, 169, 467) (see Appendix S1).
Eighteen articles (16 research papers and 2 review papers) met the inclusion criteria. Of the 16 research papers, 9 reported on debriefing models in the simulation environment and 7 in the clinical setting. The types of debriefing models found in the simulation setting tended to focus on healthcare providers' learning, while those in the clinical setting typically focused on healthcare providers' emotional reactions and resulted in positive psychological effects.
Debriefing has the potential to positively affect psychological outcomes of healthcare providers who experience patient death. The type of debriefing that is selected is a key component to achieving these positive outcomes.
This scoping review identified the debriefing frameworks used in both simulation and clinical environments following patient death events, and any associated psychological outcomes. There is a need for debriefing to occur after each death in either environment; however, there is a lack of evidence-based debriefing frameworks that can be used in both the clinical and simulation environments to promote positive psychological outcomes.
综合并绘制文献，描述在临床实践或模拟环境中经历预期和意外患者死亡的医疗保健提供者在汇报后报告的心理结果。
患者死亡既发生在临床环境中，也发生在模拟环境中，可能导致医疗保健提供者和学生产生心理压力。虽然事后汇报已经证明能够促进积极的心理结果，但对于事件的心理或情绪压力的处理并不一致。
使用阿特金和奥马利框架进行了范围审查。
在 Cochrane 图书馆、MEDLINE、CINAHL、PsycINFO、JBI 和 Scopus 数据库中进行了搜索，使用英语语言限制且没有发布日期限制。使用 Scoping Reviews (PRISMA-ScR) 清单（Annals of Internal Medicine，2018，169，467）（见附录 S1）。
符合纳入标准的有 18 篇文章（16 篇研究论文和 2 篇综述论文）。在 16 篇研究论文中，有 9 篇报道了模拟环境中的汇报模型，有 7 篇报道了临床环境中的汇报模型。在模拟环境中发现的汇报模型往往侧重于医疗保健提供者的学习，而在临床环境中则侧重于医疗保健提供者的情绪反应，并产生了积极的心理效果。
汇报有可能对经历患者死亡的医疗保健提供者的心理结果产生积极影响。选择的汇报类型是实现这些积极结果的关键组成部分。
这项范围综述确定了在模拟和临床环境中发生患者死亡事件后使用的汇报框架以及任何相关的心理结果。在这两种环境中，都需要在每次死亡后进行汇报，但缺乏可以在临床和模拟环境中使用以促进积极心理结果的基于证据的汇报框架。
