Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Denmark.
Department of Anaesthesiology, Copenhagen University Hospital, Bispebjerg, Denmark.
Acta Anaesthesiol Scand. 2024 Jan;68(1):101-121. doi: 10.1111/aas.14323. Epub 2023 Sep 5.
Family presence during resuscitation (FPDR) is a growing hospital praxis despite lack of high-quality evidence. The aim of this qualitative evidence synthesis review was to synthesize current evidence regarding healthcare professionals (HCP) perspectives on barriers and facilitating factors of FPDR and the potential impact of FPDR on HCP performance.
We conducted a systematic literature search May 17, 2023 including primary studies with qualitative study designs. We applied NVivo for data analysis. Data was coded with line-by-line coding and organized into themes and categories following the method for thematic synthesis described by Thomas and Harden to analyse data. The studies underwent quality appraisal by Critical Appraisal Skills Program. We used GRADE CERQual to assess the confidence in the evidence.
We identified 8241 articles suitable for screening, 141 articles were full text screened, and nine studies included from Australia, UK and USA. In total, 134 HCP participated, between 2005 and 2019. Most studies lacked sufficiently rigorous data analysis and findings were appraised to have moderate GRADE CERQual confidence. We identified three analytical themes ("Facilitating factors for FPDR", "Barriers for FPDR" and "How staff are affected by FPDR") with eight descriptive subthemes. One finding was of high GRADE CERQual confidence: a belief that FPDR is "the right thing to do" which was a "Facilitating factor of FPDR."
The evidence on HCP perspectives is of low to moderate confidence. The interviewed consent that FPDR is the "right thing to do", and an ethical principle of beneficence is dominant, especially regarding children.
尽管缺乏高质量的证据,但在复苏期间让家属在场(FPDR)是一种日益流行的医院实践。本定性证据综合评价综述的目的是综合当前关于医疗保健专业人员(HCP)对 FPDR 的障碍和促进因素的看法,以及 FPDR 对 HCP 表现的潜在影响的证据。
我们于 2023 年 5 月 17 日进行了系统的文献检索,包括采用定性研究设计的原始研究。我们使用 NVivo 进行数据分析。数据采用逐行编码,并根据托马斯和哈顿(Thomas and Harden)描述的主题综合方法组织成主题和类别,以分析数据。研究由批判性评估技能计划进行质量评估。我们使用 GRADE CERQual 评估证据的置信度。
我们确定了 8241 篇适合筛选的文章,对 141 篇文章进行了全文筛选,并从澳大利亚、英国和美国纳入了 9 项研究。共有 134 名 HCP 参与,研究时间在 2005 年至 2019 年之间。大多数研究缺乏足够严格的数据分析,研究结果的 GRADE CERQual 置信度被评估为中等。我们确定了三个分析主题(“FPDR 的促进因素”、“FPDR 的障碍”和“工作人员如何受到 FPDR 的影响”),并有八个描述性子主题。有一个发现具有较高的 GRADE CERQual 置信度:认为 FPDR 是“正确的事情”是 FPDR 的“促进因素”。
关于 HCP 观点的证据置信度为低到中等。受访者一致认为 FPDR 是“正确的事情”,而且善行是一种伦理原则,尤其是在儿童方面。