Wool Jesse, Irving Sharon Y, Meghani Salimah H, Ulrich Connie M
University of Pennsylvania, Philadelphia, USA.
Children's Hospital of Philadelphia, PA, USA.
J Fam Nurs. 2021 May;27(2):154-167. doi: 10.1177/1074840720975869. Epub 2021 Feb 1.
Parents are commonly responsible for making health care decisions for their seriously ill children in the pediatric intensive care unit (PICU); however, the factors influencing their decisions may vary. This integrative review examined the empirical literature between 2013 and 2018 to understand factors pertaining to parents' decision-making about serious illness care of their children in the PICU. Seventeen studies met the inclusion criteria with three key findings. First, parent-clinician communication in the PICU is critical; second, most parents want to be the final decision-maker for their critically ill child; and third, parents' emotions, support systems, and the child's clinical status impact decision-making. Parental perspectives are important to consider when discussing serious illness care decisions for critically ill children. Further inquiry is needed into how the parent-clinician encounter impacts the decision-making process and subsequent outcomes in this population.
在儿科重症监护病房（PICU），父母通常负责为身患重病的孩子做出医疗保健决策；然而，影响他们决策的因素可能各不相同。本综合综述研究了2013年至2018年间的实证文献，以了解与父母在PICU中对其子女重病护理决策相关的因素。十七项研究符合纳入标准，有三项主要发现。第一，PICU中的医患沟通至关重要；第二，大多数父母希望成为其重症患儿的最终决策者；第三，父母的情绪、支持系统以及孩子的临床状况会影响决策。在讨论重症患儿的重病护理决策时，父母的观点很重要，需要进一步探究医患接触如何影响这一人群的决策过程及后续结果。
