低等收入和中下等收入国家中重症监护病房机械通气患者的体验：系统评价方案。

Patients' experiences of mechanical ventilation in intensive care units in low- and lower-middle-income countries: protocol of a systematic review.

机构信息

Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.

Department of Anaesthesiology, Graphic Era Institute of Medical Sciences, Dehradun, Uttarakhand, India.

出版信息

Syst Rev. 2024 Aug 12;13(1):217. doi: 10.1186/s13643-024-02630-0.

DOI:10.1186/s13643-024-02630-0

PMID:39135133

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11318143/

Abstract

BACKGROUND

Mechanical ventilation (MV) in intensive care units (ICUs) is a stressful experience for patients. However, these experiences have not been systematically explored in low- and lower-middle-income countries (LLMICs). This systematic review (SR) aims to explore the patients' experiences of MV in ICUs in LLMICs and the factors influencing their experiences.

METHODS

The PICO framework will be used to operationalize the review question into key concepts: population (mechanically ventilated adult patients in ICUs), phenomenon of interest (experiences) and context (LLMICs). PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, Scopus and Web of Science will be systematically searched since database inception. Citation, reference list and PubMed-related article searching of included studies will be done to ensure literature saturation. Empirical peer-reviewed literature exploring adult patients' (aged ≥ 18 years) experiences of MV in ICUs in LLMIC will be included. All study designs (quantitative, qualitative and mixed methods) will be included. Two independent reviewers will perform screening, data extraction and critical appraisal. The mixed-methods appraisal tool (MMAT) and Popay's narrative synthesis will be used for critical appraisal and data synthesis, respectively.

DISCUSSION

This SR aims to bridge a gap in knowledge as previous evidence synthesis has described this phenomenon in developed countries. The review design, with the inclusion of quantitative, qualitative and mixed-methods studies, intends to provide a rich and in-depth exploration of the issue. The findings will be presented as themes, subthemes and their explanatory narratives. The gaps in available literature will be identified, and implications of SR findings on policy, practice and future research will be presented. The strength of this SR lies in its systematic, comprehensive, transparent, robust and explicit methodology of identifying, collating, assessing and synthesizing available evidence. By prior registration and reporting of this SR protocol, we aim to ensure transparency and accountability and minimize bias.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42024507187.

摘要

背景

重症监护病房（ICU）中的机械通气（MV）对患者来说是一种压力体验。然而，这些体验在中低收入国家（LMIC）并未得到系统的探索。本系统评价（SR）旨在探索 ICU 中 MV 患者在 LLMIC 的体验，以及影响这些体验的因素。

方法

将使用 PICO 框架将审查问题转化为关键概念：人群（ICU 中接受机械通气的成年患者）、感兴趣的现象（体验）和背景（中低收入国家）。将从数据库建立开始系统地搜索 PubMed、Embase、PsycINFO、CINAHL、Cochrane 图书馆、Scopus 和 Web of Science。将对纳入研究的参考文献和 PubMed 相关文章进行检索，以确保文献饱和。纳入的实证同行评议文献将探讨 LLMIC 中 ICU 中成年患者（年龄≥18 岁）对 MV 的体验。将纳入所有研究设计（定量、定性和混合方法）。两名独立的审查员将进行筛选、数据提取和批判性评估。将使用混合方法评估工具（MMAT）和 Popay 的叙述性综合法分别进行批判性评估和数据综合。

讨论

本 SR 旨在弥合知识差距，因为之前的证据综合已经在发达国家描述了这一现象。审查设计纳入了定量、定性和混合方法研究，旨在深入探讨这一问题。研究结果将以主题、子主题及其解释性叙述呈现。将确定现有文献中的空白，并提出 SR 结果对政策、实践和未来研究的影响。本 SR 的优势在于其识别、整理、评估和综合现有证据的系统、全面、透明、稳健和明确的方法。通过对本 SR 方案的预先注册和报告，我们旨在确保透明度和问责制，并最大程度地减少偏差。