Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Agogo, Ghana; School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom.
J Pain Symptom Manage. 2020 May;59(5):1089-1108. doi: 10.1016/j.jpainsymman.2019.11.006. Epub 2019 Nov 13.
Patients with severe burns may face distressing symptoms with a high risk of mortality as a result of their injury. The role of palliative care in burns management remains unclear.
To appraise the literature on the role of palliative care in burns management.
We used scoping review with searches in 12 databases from their inception to August 2019. The citation retrieval and retention are reported in a PRISMA statement.
39 papers comprising of 30 primary studies (26 from high-income and four from middle-income countries), four reviews, two editorials, two guidelines, and one expert board review document were retained in the review. Palliative care is used synonymously with comfort and end-of-life care in burns literature. Comfort care is mostly initiated when active treatment is withheld (early deaths) or withdrawn (late deaths), limiting its overall benefits to burn patients, their families, and health care professionals. Futility decisions are usually complex and challenging, particularly for patients in the late death category, and it is unclear if these decisions result in timely commencement of comfort care measures. Three comfort care pathways were identified, but it remained unclear how these pathways evaluated "good death" or supported the family which creates the need for the development of other evidence-based guidelines.
Palliative care is applicable in burns management, but its current role is mostly confined to the end-of-life period, suggesting that it is not been fully integrated in the management process. Evidence-based guidelines are needed to support the integration and delivery of palliative care in the burn patient population.
严重烧伤患者可能会出现痛苦的症状，且由于其伤势，死亡率较高。姑息治疗在烧伤管理中的作用仍不清楚。
评估姑息治疗在烧伤管理中的作用。
我们使用范围综述方法，在 12 个数据库中进行了从创建到 2019 年 8 月的检索。按照 PRISMA 声明报告引文检索和保留情况。
有 39 篇论文被纳入综述，其中包括 30 项原始研究（26 项来自高收入国家，4 项来自中等收入国家）、4 项综述、2 篇社论、2 项指南和 1 项专家委员会审查文件。姑息治疗在烧伤文献中与舒适护理和临终关怀同义。舒适护理主要在停止（早期死亡）或撤回（晚期死亡）积极治疗时开始，这限制了其对烧伤患者、他们的家人和医疗保健专业人员的整体益处。无益决策通常很复杂和具有挑战性，尤其是对于晚期死亡类别的患者，并且尚不清楚这些决策是否会及时开始舒适护理措施。确定了三种舒适护理途径，但仍不清楚这些途径如何评估“善终”或支持家庭，这就需要制定其他基于证据的指南。
姑息治疗适用于烧伤管理，但目前的作用主要局限于生命末期，表明它尚未完全纳入管理过程。需要循证指南来支持姑息治疗在烧伤患者人群中的整合和实施。
