School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia.
School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, Maroochydore DC, Australia.
J Adv Nurs. 2020 Sep;76(9):2222-2234. doi: 10.1111/jan.14416. Epub 2020 Jul 20.
To synthesize qualitative studies of patients' families' experiences and perceptions of end-of-life care in the intensive care unit when life-sustaining treatments are withdrawn.
Qualitative meta-synthesis.
Comprehensive search of 18 electronic databases for qualitative studies published between January 2005 - February 2019.
Meta-aggregation.
Thirteen studies met the inclusion criteria. A conceptual 'Model of Preparedness' was developed reflecting the elements of end-of-life care most valued by families: 'End-of-life communication'; 'Valued attributes of patient care'; 'Preparing the family'; 'Supporting the family'; and 'Bereavement care'.
A family-centred approach to end-of-life care that acknowledges the values and preferences of families in the intensive care unit is important. Families have unmet needs related to communication, support, and bereavement care. Effective communication and support are central to preparedness and if these care components are in place, families can be better equipped to manage the death, their sadness, loss, and grief. The findings suggest that health professionals may benefit from specialist end-of-life care education to support families and guide the establishment of preparedness.
Understanding the role and characteristics of preparedness during end-of-life care will inform future practice in the intensive care unit and may improve family member satisfaction with care and recovery from loss. Nurses are optimally positioned to address the perceived shortfalls in end-of-life care. These findings have implications for health education, policies, and standards for end-of-life care in the intensive care unit.
综合分析生命支持治疗停止时，重症监护病房患者家属对临终关怀的体验和看法。
定性元综合。
2005 年 1 月至 2019 年 2 月，对 18 个电子数据库进行全面检索，以获取发表的定性研究。
元综合聚合。
符合纳入标准的研究有 13 项。制定了一个反映临终关怀最受家属重视的元素的“准备模式”：“临终沟通”；“患者护理的有价值属性”；“为家庭做准备”；“支持家庭”；和“丧亲关怀”。
以家庭为中心的临终关怀方法承认重症监护病房中家庭的价值观和偏好是很重要的。家属在沟通、支持和丧亲关怀方面存在未满足的需求。有效的沟通和支持是准备工作的核心，如果这些护理内容到位，家庭就能更好地应对死亡、悲伤、失落和悲痛。研究结果表明，卫生专业人员可能受益于临终关怀教育的专门培训，以支持家庭并指导准备工作。
了解临终关怀期间准备工作的作用和特点，将为重症监护病房的未来实践提供信息，并可能提高家属对护理的满意度和从损失中恢复。护士是解决临终关怀方面明显不足的最佳人选。这些发现对重症监护病房的临终关怀健康教育、政策和标准具有影响。
