Li Xue, Ji Wei, Wang Dou, Xu Ying, Zhao XinYu, Liang SiYuan
Neurology Department of Healthcare Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Nursing Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
BMC Nephrol. 2025 Jul 12;26(1):382. doi: 10.1186/s12882-025-04294-x.
This study systematically reviews and synthesizes healthcare professionals' perspectives on Kidney Supportive Care (KSC) to establish an evidence base for enhancing its clinical dissemination and implementation.
KSC enhances end-of-life care quality for renal patients through a patient-centered framework integrating shared decision-making and advance care planning. This anticipatory transition management in advanced kidney disease seeks to alleviate patient/family distress while optimizing end-of-life care experiences. While KSC adoption in kidney disease care remains emergent globally, strategic investigation is critical to strengthen clinical integration.
A systematic review and integration of qualitative studies conducted in accordance with ENTREQ guidelines.
We systematically searched ten databases, including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Science Direct, CNKI, Wanfang Data, VIP, and CBM, spanning from inception to February 29, 2024. This study systematically synthesizes qualitative evidence on clinician perspectives regarding KSC in end-stage renal disease. Methodological rigor was evaluated using Joanna Briggs Institute's (JBI) 2020 Qualitative Research Appraisal Criteria. Primary study data underwent convergent synthesis following established methodology.
Eight studies yielded 10 subordinate and 5 core themes: Professional Role Challenges, Pre-implementation cognitive-ethical conflicts, Post-decisional operational barriers, Systemic and Institutional Issues, Patient-Centered and Ethical Care.
KSC is recognized as a novel therapeutic paradigm in nephrology, demonstrating significant translational promise. However, clinical implementation confronts multifaceted barriers. Future research should prioritize implementation by incorporating multidisciplinary perspectives (patients, clinicians, families). Ongoing policy framework optimization must underpin sustainable KSC implementation and progression in clinical practice.
These findings elucidate clinician perspectives regarding KSC clinical translation. Nurses' strategic formulation of integrated intervention frameworks requires prioritization as pivotal KSC stakeholders. This initiative is imperative for enhancing care delivery in ESRD clinical practice.
Not applicable.
本研究系统回顾并综合了医疗保健专业人员对肾脏支持性护理（KSC）的观点，以建立一个证据基础，以加强其临床传播和实施。
KSC通过一个整合了共同决策和预先护理计划的以患者为中心的框架，提高了肾病患者的临终护理质量。这种晚期肾病的预期过渡管理旨在减轻患者/家属的痛苦，同时优化临终护理体验。虽然KSC在全球肾病护理中的采用仍处于起步阶段，但进行战略性调查对于加强临床整合至关重要。
按照ENTREQ指南对定性研究进行系统回顾和整合。
我们系统检索了10个数据库，包括PubMed、科学网、Embase、Cochrane图书馆、护理学与健康领域数据库、科学Direct、中国知网、万方数据、维普资讯和中国生物医学文献数据库，检索时间跨度从建库至2024年2月29日。本研究系统地综合了关于临床医生对终末期肾病中KSC观点的定性证据。使用乔安娜·布里格斯研究所（JBI）2020年定性研究评估标准对方法的严谨性进行评估。根据既定方法对原始研究数据进行了聚合综合。
八项研究产生了10个次要主题和5个核心主题：专业角色挑战、实施前的认知-伦理冲突、决策后的操作障碍、系统和机构问题、以患者为中心和符合伦理的护理。
KSC被认为是肾脏病学中的一种新型治疗模式，具有显著的转化前景。然而，临床实施面临多方面的障碍。未来的研究应通过纳入多学科视角（患者、临床医生、家属）来优先考虑实施。持续的政策框架优化必须为临床实践中KSC的可持续实施和发展提供支持。
这些发现阐明了临床医生对KSC临床转化的观点。护士作为关键的KSC利益相关者，战略制定综合干预框架需要被优先考虑。这一举措对于提高终末期肾病临床实践中的护理质量至关重要。
不适用。
