Clinical Nursing, School of Nursing, Midwifery & Health Systems, 8797University College Dublin, Ireland.
8870Our Lady's Hospice & Care Services, Dublin, Ireland.
Am J Hosp Palliat Care. 2022 Sep;39(9):1105-1120. doi: 10.1177/10499091211057049. Epub 2021 Dec 11.
: To identify the nature of the evidence reporting hospital-based palliative and end-of-life care during the COVID-19 pandemic. : The COVID-19 pandemic has seen an increase in the numbers of seriously ill people being cared for across all health services worldwide. Due to the rapid progression of severe symptoms, the majority of staff working in hospitals and other healthcare centres were providing end-of-life care. Little is known about the level of hospital-based palliative care service provided during the COVID-19 pandemic, particularly during surges in admission rates with an increased number of deaths accruing. A scoping review was conducted to search and select potential studies. The scoping review was guided by the framework of Arskey and O'Malley and advanced by the use of the methodology of the Joanna Briggs Institute. Eighteen studies published between March 2020 and July 2021 were identified. Three broad categories included overall management strategy and logistics, symptom prevalence and management of patients with COVID-19 and end-of-life care needs within the current pandemic. This review highlights increased awareness and knowledge of palliative and end-of-life care provided in hospitals. The review also highlights the response of hospital-based palliative care teams to an evolving crisis, within the context of developed health systems under sustained and overwhelming pressure. Newly established clinical links and referral pathways developed during the initial COVID-19 surge between hospital-based palliative care and other healthcare teams, be continued and further enhanced. Understanding of the role of specialist palliative care providers in supporting palliative and end-of-life care within the hospital setting needs further investigation.
明确 COVID-19 大流行期间基于医院的姑息治疗和临终关怀的证据报告性质。
COVID-19 大流行期间，全球所有卫生服务机构中需要护理的重症患者数量有所增加。由于严重症状迅速恶化，大多数在医院和其他医疗机构工作的医护人员都在提供临终关怀。关于 COVID-19 大流行期间提供的基于医院的姑息治疗服务水平知之甚少，特别是在入院率激增和死亡人数增加的情况下。
开展了范围综述以搜索和选择潜在的研究。该范围综述以 Arskey 和 O'Malley 的框架为指导，并通过使用 Joanna Briggs 研究所的方法学加以推进。共确定了 18 项发表于 2020 年 3 月至 2021 年 7 月之间的研究。三个广泛的类别包括总体管理策略和后勤、COVID-19 患者的症状流行和管理以及当前大流行期间的临终关怀需求。
该综述强调了人们对医院提供的姑息治疗和临终关怀的认识和了解有所提高。该综述还强调了在面临持续和压倒性压力的发达卫生系统中，医院姑息治疗团队对不断演变的危机的应对情况。在 COVID-19 疫情初期，在医院姑息治疗与其他医疗机构之间新建立的临床联系和转诊途径应继续并进一步加强。还需要进一步研究了解专科姑息治疗提供者在支持医院环境中的姑息治疗和临终关怀方面的作用。
