Karunashraya Institute for Palliative Care Education and Research, Bangalore Hospice Trust, Karunashraya, Bangalore, India.
Department of Palliative Medicine and Supportive Care, Kasturba Medical College Manipal, Manipal Academy of Higher Education, India.
J Crit Care. 2022 Oct;71:154115. doi: 10.1016/j.jcrc.2022.154115. Epub 2022 Jul 27.
Death is common in intensive care units, and integrating palliative care enhances outcomes. Most research has been conducted in high-income countries. The aim is to understand what is known about the type and topics of research on the provision of palliative care within intensive care units in low- and middle-income countries MATERIALS AND METHODS: Scoping review with nine databases systematically searched for literature published in English on palliative care in intensive care units in low- and middle- income settings (01/01/1990 to 31/05/2021). Two reviewers independently checked search results and extracted textual data, which were analyzed and represented as themes.
Thirty papers reported 19 empirical studies, two clinical case reports and six discussion papers. Papers originated from Asia and Africa, primarily using observational designs and qualitative approaches, with no trials or other robust evaluative or comparative studies. No studies directly sought data from patients or families. Five areas of research focus were identified: withholding and withdrawing treatment; professional knowledge and skills; patient and family views; culture and context; and costs of care.
Palliative care in intensive care units in low-and middle-income countries is understudied. Research focused on the specific needs of intensive care in low- and middle-income countries is required to ensure optimal patient outcomes.
重症监护病房中死亡较为常见，而姑息治疗的介入可以改善预后。大多数研究都是在高收入国家开展的。本研究旨在了解在中低收入国家的重症监护病房中开展姑息治疗的相关研究的类型和主题。
本研究采用范围综述，检索了 1990 年 1 月 1 日至 2021 年 5 月 31 日发表的关于中低收入国家重症监护病房姑息治疗的英文文献，共使用了 9 个数据库。两位评审员独立检查了检索结果并提取了文本数据，然后对其进行了分析并以主题的形式呈现。
30 篇论文报告了 19 项实证研究、2 项临床病例报告和 6 项讨论论文。这些论文来自亚洲和非洲，主要采用观察性设计和定性方法，没有试验或其他稳健的评估或比较研究。没有研究直接从患者或家属那里获取数据。确定了五个研究重点领域：治疗的暂停和终止；专业知识和技能；患者和家属的观点；文化和背景；以及护理成本。
在中低收入国家的重症监护病房中开展姑息治疗的研究还比较少。需要针对中低收入国家的重症监护的具体需求开展研究，以确保患者获得最佳预后。
