决策辅助工具在ICU患者生命支持治疗中应用的范围综述

doi:10.3761/j.issn.2096-7446.2025.07.021

摘要/Abstract

摘要：

目的对ICU生命支持治疗中的决策辅助工具（decision aid， DA）进行范围综述，明确ICU中DA的应用现状、内容要素及应用效果，为国内ICU患者关于生命支持治疗DA的开发提供指导。方法检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库、维普数据库。检索时限为建库至2024年5月7日。对纳入文献进行汇总和分析。结果共纳入21篇文献，DA涵盖的主题包括特定疾病、维持生命的治疗、预先护理计划、临终关怀。DA的内容要素包括明确治疗选择、信息支持、与治疗选项有关的风险利弊说明、澄清价值观、引导决策制订。评价指标包括决策过程质量、决策质量、DA对患方及医疗机构的影响、可行性、可用性、可接受性。结论 DA在ICU生命支持治疗中表现出了良好的效果，ICU中的DA主要集中在特定的疾病和生命支持治疗及护理目标上，而ICU大多数患者多病共存，生命支持治疗措施也不止一项，应充分考虑国内现状，开发适用于中国ICU患者生命支持治疗的DA，以满足不同群体的个性化需求。

关键词: 重症监护病房, 决策辅助工具, 范围综述, 循证护理学

Abstract:

Objective To conduct a scoping review of decision aids（DA） for patients with life-support treatment in ICU，identify the application status of DA in ICU，content elements and application effects，provide guidance for the development of DA for life support therapy in ICU patients in China. Methods PubMed，Web of Science，Embase，Cochrane Library，CNKI，Wanfang database，CBM and VIP database were searched. The retrieval time limit was from the establishment of databases until May 7，2024. The included literature was summarized and analyzed. Results A total of 21 articles were included，and topics on DA included specific diseases，life-sustaining treatments，advance care planning，hospice care. The content elements of DA included clear treatment options，information support，risks and benefits associated with treatment options，clarifying values and guiding decision-making. The evaluation indexes included the quality of the decision making process，decision quality，the impact of DA on patients and medical institutions，feasibility，usability and acceptability. Conclusion DA has shown good effects in ICU life support treatment. DA mainly focuses on specific diseases，life support treatment and nursing goals in ICU，while most patients coexist with multiple diseases，the life support treatment measures are not limited to one. We should fully consider the domestic situation and develop DA suitable for ICU patients with life-support treatment in China to meet the individual needs of different groups.

Key words: Intensive Care Units, Decision Aids, Scoping Review, Evidence-Based Nursing

周红芳, 岳伟岗, 吴雨晨, 何成英, 兰旭红, 王恒阳, 贾东珲, 王倩, 张志刚. 决策辅助工具在ICU患者生命支持治疗中应用的范围综述[J]. 中华急危重症护理杂志, 2025, 6(7): 885-890.

ZHOU Hongfang, YUE Weigang, WU Yuchen, HE Chengying, LAN Xuhong, WANG Hengyang, JIA Donghui, WANG Qian, ZHANG Zhigang. The application of decision aids for patients with life-support treatment in ICU：a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 885-890.

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