Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway.
Division of Emergencies and Critical Care, Pediatric Intensive Care, Oslo University Hospital, Oslo, Norway.
J Clin Nurs. 2023 Sep;32(17-18):6012-6027. doi: 10.1111/jocn.16728. Epub 2023 Apr 21.
To synthesise the qualitative evidence regarding the role of critical care nurses in the decision-making process of withdrawing life-sustaining treatment in critically ill adults.
Qualitative systematic review.
This qualitative systematic review employed the guidelines of Bettany-Saltikov and McSherry. The review was reported according to the ENTREQ checklist. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data. Data were synthesised using thematic synthesis.
CINAHL, MEDLINE and EMBASE were searched for studies published between January 2001 and November 2021.
Twenty-three studies were included. Three analytical themes were synthesised: performing ethical decision-making to safeguard patients' needs rights, and wishes; tailoring a supporting role to guide the family's decision-making process; and taking on the role of the middleman by performing coordination.
The role of the critical care nurses in the decision-making process in withdrawal of life-sustaining treatment requires experience and the development of the clinical perspective of critical care nurses.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Enhanced knowledge of the decision-making process of withdrawing life-sustaining treatment can prepare critical care nurses to be more equipped to master this role and enhance their ability to handle the emotional and moral stress associated with this part of the critical care unit.
The literature reveals the complex and challenging role of critical care nurses during the decision-making process of withdrawing life-sustaining treatment. Critical care nurses perform ethical decision-making to safeguard patients' concerns, guide the family's decision-making process and take on the role of the middleman. The findings have implications for critical nurses working in critical care units in hospitals and for educators and students in training in critical care nursing.
No patient or public contribution was included.
综合有关重症监护护士在决定停止重症成人生命支持治疗过程中作用的定性证据。
定性系统综述。
本定性系统综述采用 Bettany-Saltikov 和 McSherry 的指南。根据 ENTREQ 清单报告综述。两位作者独立评估合格性、评估方法学质量并提取数据。使用主题合成法对数据进行综合。
CINAHL、MEDLINE 和 EMBASE 检索了 2001 年 1 月至 2021 年 11 月期间发表的研究。
纳入了 23 项研究。综合了三个分析主题：履行伦理决策以保护患者的需求、权利和意愿；量身定制支持角色以指导家庭的决策过程；通过协调承担中间人角色。
重症监护护士在停止生命支持治疗决策过程中的作用需要经验和重症监护护士临床视角的发展。
对专业和/或患者护理的影响：增强对停止生命支持治疗决策过程的了解可以使重症监护护士更有能力掌握这一角色，并提高他们处理重症监护病房这一部分相关情感和道德压力的能力。
文献揭示了重症监护护士在停止生命支持治疗决策过程中复杂且具有挑战性的角色。重症监护护士进行伦理决策以保护患者的关注，指导家庭的决策过程，并承担中间人的角色。研究结果对在医院重症监护病房工作的重症监护护士、重症监护护理培训的教育者和学生具有影响。
未包括患者或公众贡献。
