Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Am J Perinatol. 2021 Aug;38(S 01):e318-e329. doi: 10.1055/s-0040-1710031. Epub 2020 Apr 24.
The aim of this study is to assess the impact of specialized pediatric palliative care (PPC) on neonates with life-limiting conditions compared to standard care.
MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, Scopus, and Embase databases were searched from January 2000 to September 2018. Randomized clinical trials, experimental or observational studies, and secondary administrative database analyses published in English, Spanish, French, and German were included. Two independent reviewers extracted data, and used the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool for quality analysis. Discrepancies were resolved as a team.
From the 37,788 records obtained, only eight articles met the inclusion criteria. A meta-analysis was not possible due to the heterogeneity in how the outcomes were defined; however, a qualitative synthesis of the results was possible; organizing outcomes into eight different categories: psychological, social and spiritual support; communication; location of care; symptom management; bereavement care; predicted versus actual neonatal outcomes; and parental coping, stress, and satisfaction.
Specialized versus may have an impact on neonates with life-limiting conditions and their families. More studies that evaluate the impact of specialized versus in neonates with sound statistical analysis is warranted.
本研究旨在评估与标准护理相比，专门的儿科姑息治疗（PPC）对患有生命有限疾病的新生儿的影响。
从 2000 年 1 月至 2018 年 9 月，检索了 MEDLINE、PsycINFO、Cochrane 中央对照试验注册库、Web of Science、CINAHL、Scopus 和 Embase 数据库。纳入了发表在英语、西班牙语、法语和德语的随机临床试验、实验或观察性研究以及二级行政数据库分析。两名独立的审查员提取数据，并使用纽卡斯尔-渥太华量表和 Cochrane 偏倚风险工具进行质量分析。分歧由团队解决。
从获得的 37788 条记录中，只有 8 篇文章符合纳入标准。由于如何定义结局的异质性，无法进行荟萃分析；然而，可以对结果进行定性综合；将结局组织成八个不同的类别：心理、社会和精神支持；沟通；护理地点；症状管理；丧亲关怀；预测与实际新生儿结局；以及父母应对、压力和满意度。
专门的儿科姑息治疗可能对患有生命有限疾病的新生儿及其家庭产生影响。需要更多的研究来评估专门的儿科姑息治疗对具有良好统计分析的新生儿的影响。
