Advanced Medical Emergency Department and Critical Care Centre, Maebashi Red Cross Hospital, Gunma, Japan.
Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Anaesth Crit Care Pain Med. 2024 Feb;43(1):101330. doi: 10.1016/j.accpm.2023.101330. Epub 2023 Nov 19.
We aimed to synthesize published data on and identify factors associated with healthcare providers' satisfaction with end-of-life care for critically ill adults.
Electronic databases were searched from inception to January 23, 2023. We included trials involving adults admitted to intensive care units (ICUs) or high-dependency units to evaluate palliative care interventions.
The inclusion criteria were as follows: 1) Adult patients (age ≥18 years) or their family members admitted to the ICU or a high-dependency unit; 2) ICU palliative care interventions; 3) Randomized and non-randomized controlled trials; and 4) Full-text, peer-reviewed articles published in English. Two reviewers screened and extracted the data and assessed bias risk. The primary outcome was an improvement in the healthcare providers' satisfaction based on the validated scales.
Out of 12 studies, 9 investigated combined dimension intervention. Healthcare providers' satisfaction improved in 6/7 (85.7%) of the studies testing educational intervention, 5/7 (71.4%) studies testing the effectiveness of palliative care team involvement, 4/5 (80%) of studies testing communication interventions, while 0/2 (0%) study testing ethic consultations.
Most of the tested palliative care interventions were associated with improved healthcare provider satisfaction in intensive care units. The impacts of such intervention on mental health and burden remain to be investigated in this field.
我们旨在综合已发表的数据，并确定与重症成人临终关怀服务提供者满意度相关的因素。
从建库至 2023 年 1 月 23 日，我们检索了电子数据库。我们纳入了涉及入住重症监护病房（ICU）或高依赖病房的成年人的试验，以评估姑息治疗干预措施。
纳入标准如下：1）年龄≥18 岁的成年患者或其家属入住 ICU 或高依赖病房；2）ICU 姑息治疗干预；3）随机和非随机对照试验；4）全文为英文同行评审的已发表文章。两名审查员筛选和提取数据并评估偏倚风险。主要结局是基于经过验证的量表评估医疗保健提供者满意度的提高。
在 12 项研究中，有 9 项研究调查了综合维度干预。在 7 项测试教育干预的研究中，有 6/7（85.7%）的研究发现医疗保健提供者的满意度提高，在 7 项测试姑息治疗团队参与有效性的研究中，有 5/7（71.4%）的研究发现医疗保健提供者的满意度提高，在 5 项测试沟通干预的研究中，有 4/5（80%）的研究发现医疗保健提供者的满意度提高，而在 2 项测试伦理咨询的研究中，均未发现医疗保健提供者的满意度提高。
大多数测试的姑息治疗干预措施与 ICU 中医疗保健提供者满意度的提高相关。在该领域，仍需研究此类干预措施对心理健康和负担的影响。
