Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
Dr. José de Carvalho Florence Municipal Hospital, São José dos Campos, SP, Brazil.
Enferm Intensiva (Engl Ed). 2023 Jul-Sep;34(3):156-172. doi: 10.1016/j.enfie.2023.08.008.
Patients in palliative care are found in different places where care is provided, including the intensive care environment with important role of the nursing staff.
The aim of this systematic review was to answer the following question: which nursing interventions are aimed to the palliative care patients who are in the intensive care unit (ICU).
US National Library of Medicine (PUBMED), Virtual Health Library (BVS), SciELO, The Cochrane Library (Cochrane) and Lilacs databases were used.
After applying inclusion and exclusion criteria in accordance with the PRISMA method, a total of 36 entries published between 2010 and 2020 were used.
The records extracted were analyzed from a qualitative approach, so no statistical analysis was carried out.
The findings demonstrated that the interventions that focus on promoting the patient's autonomy and respect their needs on ICU involves effective communication, promoting shared decision with patient and family, individualize care for each patient including the family on the daily care and decisions, maintaining basic nursing care as hygiene and comfort and encouraging self-care, as well as the involvement of nursing palliative care specialists the care is important. Other interventions included promoting a continuing education program for the nursing staff and other professionals involved in caring for patients in palliative care at ICU.
This review highlighted the need for specific nursing interventions aimed at palliative care patients at ICU to promote patient autonomy and the focus on patient needs, always sharing decisions with the patient and family. However, it showed that there is a need for the continuous training of the nursing staff because factors such as the nurses' lack of technical-scientific knowledge and, concomitantly, the absence of a standardized and specific intervention model linked to a bureaucratic system, make it difficult to carry out a specialized care for this type of patient.
在提供护理的不同场所都能发现姑息治疗患者，包括重症监护环境，护理人员在其中发挥着重要作用。
本系统评价旨在回答以下问题：针对在重症监护病房（ICU）的姑息治疗患者，有哪些护理干预措施？
美国国家医学图书馆（PubMed）、虚拟卫生图书馆（BVS）、科学电子图书馆（SciELO）、考科兰图书馆（Cochrane）和巴西医学文献数据库（Lilacs）等数据库被用于检索。
根据 PRISMA 方法应用纳入和排除标准后，共使用了 2010 年至 2020 年期间发表的 36 项研究。
提取的记录从定性的角度进行了分析，因此没有进行统计分析。
研究结果表明，在 ICU 中，关注促进患者自主性和满足其需求的干预措施包括有效沟通、促进与患者和家属的共同决策、为每位患者（包括家属）制定个体化的日常护理和决策、维持基本的护理关怀，如卫生和舒适，并鼓励患者自我护理，以及姑息治疗护理专家参与护理非常重要。其他干预措施包括为在 ICU 中护理姑息治疗患者的护理人员和其他专业人员开展继续教育计划。
本综述强调了 ICU 姑息治疗患者需要特定的护理干预措施，以促进患者自主性和关注患者需求，始终与患者和家属共同做出决策。然而，研究结果表明，护理人员需要持续培训，因为护理人员缺乏技术-科学知识，以及缺乏与官僚制度相关的标准化和特定干预模式等因素，使得为这类患者提供专业护理变得困难。
