急诊患者临终照护沟通策略的最佳证据总结

doi:10.3761/j.issn.2096-7446.2024.04.014

摘要/Abstract

摘要： 目的检索并总结急诊科护士参与临终照护（end-of-life care,EoLC）相关沟通策略的最佳证据。方法确立循证问题,依据“6S”证据模型,自上而下计算机检索UpToDate、BMJ最佳临床实践、英国国家卫生与临床优化研究所指南网、加拿大安大略注册护士协会网站、国际指南网、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库、Cochrane Library、PubMed、Web of Science、Embase、CINAHL、万方数据库、中国知网、维普数据库、中国生物医学文献数据库、医脉通等数据库及网站中关于急诊护士参与临终照护沟通策略的相关文献,包括临床决策、实践指南、证据总结、专家共识、系统评价。检索时间为建库至2023年3月。由2名经过循证医学培训的研究人员采用JBI循证卫生保健中心的文献评价标准和证据分级系统,进行文献质量评价及证据级别评定,并根据主题进行证据提取、归纳和汇总。结果最终纳入10篇文献,包括指南2篇、临床决策3篇、系统评价5篇,总结出29条证据。结论急诊护士参与临终照护沟通策略的最佳证据总结形成过程严谨、科学,具有一定的临床实用性,急诊医护人员需结合文化背景、临床情境、患者意见,为临终患者提供针对性的临终照护服务。

关键词: 急诊室, 医院, 临终关怀与安宁医护, 沟通策略, 循证护理学, 证据总结

Abstract: Objective To retrieve and summarize the best evidence of communication strategies for emergency department nurses' participation in end-of-life care（EoLC）. Methods We established evidence-based problems. According to the "6S" evidence model,we searched from top to down,including UpToDate,BMJ best clinical practice,British National Institute for Health and Care Excellence（NICE）,Canadian Ontario Registered Nurses Association（RNAO） website,International Guide Network,Australian Joanna Briggs Institute（JBI） Evidence-based Health Care Center Library,Cochrane Library,PubMed,Web of Science,Embase,CINAHL,Wanfang Database,CNKI,VIP Database,CBM,Yimaitong and other databases and websites for relevant literature on the communication strategy of emergency nurses' participation in EoLC which included clinical decision-making system,practice guidelines,evidence summary,consensus,and systematic review. The retrieval time was from the establishment of the database to March 2023.Two researchers who received training in evidence-based medicine used the literature evaluation criteria and evidence grading system of JBI evidence-based health care center to evaluate literature quality and evidence level,and extract,induce and summarize evidence according to the topic. Results 10 articles were finally included,including 2 guidelines,3 clinical decisions,5 systematic evaluations,and 29 pieces of evidence were summarized. Conclusion The formation of best evidence for emergency nurses to participate in the EoLC communication strategy is rigorous and scientific,with a certain clinical practicability. Emergency medical staff need to combine cultural background,clinical situation and patient opinions to provide targeted EoLC services for terminally ill patients.

Key words: Emergency Service, Hospital, Hospice and Palliative Nursing, Communication Strategy, Evidence-Based Nursing, Evidence Summary

侯海龙, 肖适崎, 李贺, 程显娟, 董天娇, 孙善文. 急诊患者临终照护沟通策略的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(4): 359-366.

HOU Hailong, XIAO Shiqi, LI He, CHENG Xianjuan, DONG Tianjiao, SUN Shanwen. Summary of the best evidence for the communication strategy of end-of-life care for emergency nurses[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(4): 359-366.

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