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国际姑息治疗研究重点:系统评价。

International palliative care research priorities: A systematic review.

机构信息

Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland.

UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural Sciences, University College Dublin, Belfield, Dublin 4, Ireland.

出版信息

BMC Palliat Care. 2020 Feb 3;19(1):16. doi: 10.1186/s12904-020-0520-8.

Abstract

BACKGROUND

There has been increasing evidence and debate on palliative care research priorities and the international research agenda. To date, however, there is a lack of synthesis of this evidence, examining commonalities, differences, and gaps. To identify and synthesize literature on international palliative care research priorities originating from Western countries mapped to a quality assessment framework.

METHODS

A systematic review of several academic and grey databases were searched from January 2008-June 2019 for studies eliciting research priorities in palliative care in English. Two researchers independently reviewed, critically appraised, and conducted data extraction and synthesis.

RESULTS

The search yielded 10,235 articles (academic databases, n = 4108; grey literature, n = 6127), of which ten were included for appraisal and review. Priority areas were identified: service models; continuity of care; training and education; inequality; communication; living well and independently; and recognising family/carer needs and the importance of families. Methodological approaches and process of reporting varied. There was little representation of patient and caregiver driven agendas. The priorities were mapped to the Donabedian framework for assessing quality reflecting structure, process and outcomes and key priority areas.

CONCLUSIONS

Limited evidence exists pertaining to research priorities across palliative care. Whilst a broad range of topics were elicited, approaches and samples varied questioning the credibility of findings. The voice of the care provider dominated, calling for more inclusive means to capture the patient and family voice. The findings of this study may serve as a template to understand the commonalities of research, identify gaps, and extend the palliative care research agenda.

摘要

背景

在姑息治疗研究重点和国际研究议程方面,已经有越来越多的证据和争论。然而,迄今为止,缺乏对这些证据的综合分析,以检查其共同点、差异和差距。本研究旨在确定并综合源自西方国家的姑息治疗国际研究重点文献,并将其映射到质量评估框架中。

方法

从 2008 年 1 月至 2019 年 6 月,对几个学术和灰色文献数据库进行了系统检索,以寻找以英语阐述姑息治疗研究重点的研究。两名研究人员独立进行了审查、批判性评价,并进行了数据提取和综合。

结果

检索结果共产生了 10235 篇文章(学术数据库,n=4108;灰色文献,n=6127),其中有 10 篇被纳入评估和综述。确定了优先领域:服务模式;连续护理;培训和教育;不平等;沟通;良好和独立生活;以及认识家庭/照顾者的需求和家庭的重要性。方法学方法和报告过程各不相同。几乎没有患者和护理人员驱动的议程的代表。这些优先事项被映射到评估质量的 Donabedian 框架,反映了结构、过程和结果以及关键优先领域。

结论

姑息治疗领域的研究重点证据有限。虽然提出了广泛的议题,但方法和样本各不相同,这对研究结果的可信度提出了质疑。护理提供者的声音占主导地位,呼吁采取更具包容性的方式来捕捉患者和家庭的声音。本研究的结果可以作为理解研究共同点、确定差距和扩展姑息治疗研究议程的模板。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1021/6998205/c31552f67abf/12904_2020_520_Fig1_HTML.jpg

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