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重症监护病房中具有不同文化和语言背景的临床医生、患者和家属对临终关怀的观点和见解:系统评价方案。

Perspectives and insights of critical care clinicians, patients and families from culturally and linguistically diverse backgrounds around end-of-life care in an ICU: a scoping review protocol.

机构信息

Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia

Intensive Care Unit, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.

出版信息

BMJ Open. 2024 Nov 2;14(11):e090168. doi: 10.1136/bmjopen-2024-090168.

Abstract

OBJECTIVE

Protocol to explore what is known about communication between critical care providers and patients and families from culturally and linguistically diverse backgrounds (defined as people who are either from minority ethnic groups, non-English-speaking backgrounds who may have diverse cultural, linguistic, spiritual and religious affiliations and opinions) about death, dying, end-of-life care and organ donation in the intensive care unit (ICU).

INTRODUCTION

Patients from culturally and linguistically diverse backgrounds experience barriers to optimised care when admitted to the ICU. These barriers appear to derive from differences in language, cultural, societal and ethical expectations between patients, their families and healthcare professionals. These barriers may significantly impact the delivery of end-of-life care to patients from culturally and linguistically diverse backgrounds. Therefore, this has the potential for inadequate management of medical, psychological and existential distress.

INCLUSION CRITERIA

Studies of all designs reporting for adult (age ≥18 years) patients and family members from culturally and linguistically diverse backgrounds at end-of-life in the ICU setting will be included. Studies that report results for patients aged <18 years or that are based outside the ICU will be excluded.

METHODS

Relevant sources will be retrieved, and their citation details will be imported into the Joanna Briggs Institute (JBI) System for the Unified Management, Assessment and Review of Information. This scoping review was guided by the JBI methodology for scoping reviews and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A systematic search was conducted in EBSCOhost, Web of Science, PubMed Central and SciELO, OVID Medline, CINAHL, and Scopus, limited to English-language publications, without date limitation. Key study characteristics and findings will be extracted using a data extraction tool developed by the reviewers. Anticipating heterogeneous study designs, findings will be presented as a thematic synthesis.

ETHICS AND DISSEMINATION

This is a protocol for a scoping review, formal ethics approval from the Human Research Ethics Committee (HREC) of the Local Health Network will be obtained for research projects that could potentially stem from this review and will then be subsequently disseminated through proper channels.

摘要

目的

探索重症监护病房(ICU)中来自文化和语言背景多样化的患者(被定义为少数族裔群体、非英语为母语的人,他们可能具有不同的文化、语言、精神和宗教背景及观点)与医护人员就死亡、临终、终末关怀和器官捐献相关的沟通情况。

介绍

来自文化和语言背景多样化的患者在入住 ICU 时会面临优化治疗的障碍。这些障碍似乎源于患者、其家属和医护人员之间的语言、文化、社会和伦理期望的差异。这些障碍可能会对来自文化和语言背景多样化的患者的临终关怀产生重大影响。因此,这可能导致对患者的医疗、心理和存在困境的管理不足。

纳入标准

本研究纳入了 ICU 临终关怀环境中来自文化和语言背景多样化的成年(年龄≥18 岁)患者和家属的所有设计研究。不包括报告年龄<18 岁患者或基于 ICU 之外的研究。

方法

将检索相关来源,并将其引用详细信息导入 Joanna Briggs 研究所(JBI)统一管理、评估和信息审查系统。本范围综述遵循 JBI 范围综述方法,并根据系统评价和荟萃分析扩展的首选报告项目进行报告。在 EBSCOhost、Web of Science、PubMed Central 和 SciELO、OVID Medline、CINAHL 和 Scopus 中进行了系统检索,仅检索英文出版物,无时间限制。使用评审员开发的数据提取工具提取关键研究特征和发现。由于预计研究设计存在异质性,研究结果将以主题综合的形式呈现。

伦理与传播

这是一项范围综述的方案,对于可能源于本综述的研究项目,将从当地卫生网络的人类研究伦理委员会(HREC)获得正式的伦理批准,然后通过适当的渠道进行传播。

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