Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa.
BMJ Open. 2023 Mar 16;13(3):e071116. doi: 10.1136/bmjopen-2022-071116.
The aim of this study was to map existing emergency medical services (EMS) and palliative care literature by answering the question, what literature exists concerning EMS and palliative care? The sub-questions regarding this literature were, (1) what types of literature exist?, (2) what are the key findings? and (3) what knowledge gaps are present?
A scoping review of literature was performed with an a priori search strategy.
MEDLINE via Pubmed, Web of Science, CINAHL, Embase via Scopus, PsycINFO, the University of Cape Town Thesis Repository and Google Scholar were searched.
Empirical, English studies involving human populations published between 1 January 2000 and 24 November 2022 concerning EMS and palliative care were included.
Two independent reviewers screened titles, abstracts and full texts for inclusion. Extracted data underwent descriptive content analysis and were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines.
In total, 10 725 articles were identified. Following title and abstract screening, 10 634 studies were excluded. A further 35 studies were excluded on full-text screening. The remaining 56 articles were included for review. Four predominant domains arose from included studies: (1) EMS' palliative care role, (2) challenges faced by EMS in palliative situations, (3) EMS and palliative care integration benefits and (4) proposed recommendations for EMS and palliative care integration.
EMS have a role to play in out-of-hospital palliative care, however, many challenges must be overcome. EMS provider education, collaboration between EMS and palliative systems, creation of EMS palliative care guidelines/protocols, creation of specialised out-of-hospital palliative care teams and further research have been recommended as solutions. Future research should focus on the prioritisation, implementation and effectiveness of these solutions in various contexts.
本研究旨在通过回答“关于紧急医疗服务(EMS)和姑息治疗的文献有哪些?”这一问题来绘制现有的 EMS 和姑息治疗文献图谱。该问题的子问题为:(1)存在哪些类型的文献?(2)主要发现是什么?(3)存在哪些知识空白?
这是一项文献范围的综述,采用了事先制定的搜索策略。
通过 Pubmed 检索 MEDLINE、通过 Scopus 检索 Web of Science、CINAHL、Embase、PsycINFO、开普敦大学论文库和 Google Scholar。
纳入了 2000 年 1 月 1 日至 2022 年 11 月 24 日期间发表的涉及 EMS 和姑息治疗的、以人类为研究对象的、实证性的英文研究。
两名独立的评审员筛选标题、摘要和全文以确定是否纳入。提取的数据经过描述性内容分析,并根据系统评价和荟萃分析扩展的首选报告项目报告。
共确定了 10725 篇文章。经过标题和摘要筛选,排除了 10634 项研究。进一步在全文筛选中排除了 35 项研究。其余 56 篇文章纳入审查。纳入的研究主要有以下四个领域:(1)EMS 的姑息治疗角色,(2)EMS 在姑息治疗情境中面临的挑战,(3)EMS 和姑息治疗整合的好处,(4)EMS 和姑息治疗整合的建议。
EMS 在院外姑息治疗中发挥作用,但必须克服许多挑战。EMS 提供者教育、EMS 和姑息治疗系统之间的合作、制定 EMS 姑息治疗指南/方案、创建专门的院外姑息治疗团队以及进一步的研究已被推荐作为解决方案。未来的研究应侧重于各种背景下这些解决方案的优先级、实施和有效性。