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儿科姑息治疗中的家庭会议:一项综合综述。

Family meetings in paediatric palliative care: an integrative review.

作者信息

Bradford Natalie, Rolfe Melanie, Ekberg Stuart, Mitchell Geoffrey, Beane Theresa, Ferranti Kahli, Herbert Anthony

机构信息

Centre for Healthcare Transformation at Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia

Centre for Healthcare Transformation at Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.

出版信息

BMJ Support Palliat Care. 2021 Sep;11(3):288-295. doi: 10.1136/bmjspcare-2020-002333. Epub 2020 Jul 17.

Abstract

OBJECTIVE

Our aim was to synthesise the available evidence surrounding the structure, processes and outcomes of family meetings in the paediatric palliative care literature.

METHODS

We undertook an integrative literature review informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol was registered with PROSPERO (CRD42019138938). Electronic databases were systematically search using keywords and hand searching of reference articles and grey literature was also completed.

RESULTS

Ten empirical studies and five theoretical articles were included in the synthesis. Empirical studies provided more information about meeting structure, whereas theoretical articles more frequently described a desired process for planning and undertaking meetings. No articles identified how the success of a meeting was defined or made recommendations for doing so. Despite reports that family meetings are commonly occurring, few articles described outcomes from either the family or clinician perspectives.

CONCLUSIONS

Family meetings are essential communication strategies commonly used in paediatric palliative care, yet there is little guidance about how meetings should be organised and conducted, who should participate and when they should occur. The limited data available on the outcomes of family meetings suggest improvements are required to meet the needs of families. We present a framework that synthesises the available evidence. The framework offers an overview of the elements to consider when planning for and undertaking family meetings in paediatric palliative care and may be useful for both clinicians and researchers.

摘要

目的

我们的目的是综合儿科姑息治疗文献中有关家庭会议的结构、流程和结果的现有证据。

方法

我们根据系统评价和荟萃分析的首选报告项目指南进行了一项综合文献综述。该方案已在国际前瞻性系统评价注册库(PROSPERO,注册号:CRD42019138938)注册。使用关键词对电子数据库进行了系统检索,并对参考文献进行了手工检索,同时也完成了灰色文献的检索。

结果

共有10项实证研究和5篇理论文章纳入了本次综合分析。实证研究提供了更多关于会议结构的信息,而理论文章则更频繁地描述了规划和召开会议的理想流程。没有文章明确说明如何定义会议的成功,也没有提出相关建议。尽管有报道称家庭会议普遍存在,但很少有文章从家庭或临床医生的角度描述会议结果。

结论

家庭会议是儿科姑息治疗中常用的重要沟通策略,但对于如何组织和开展会议、谁应参与以及何时召开会议,几乎没有指导意见。关于家庭会议结果的现有数据有限,表明需要改进以满足家庭的需求。我们提出了一个综合现有证据的框架。该框架概述了在规划和开展儿科姑息治疗家庭会议时需要考虑的要素,可能对临床医生和研究人员都有用。

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