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ICUにおける緩和ケア実施の障壁とファシリテーターを三方的な視点から探求する: 質的体系的レビューとメタアグリゲーション
Yuting Shen1, Hui Xu2,3, Yinghui Zou3
1China Medical University, Shenyang, Liaoning, China.
BMJ open
|August 26, 2025
まとめ
集中治療室 (ICU) の緩和ケアには,感情的サポート,コミュニケーション,ケアモデル,リソース,教育が影響します. これらの領域の改善はICUでの患者と家族の経験を高めることができます.
科学分野:
- クリティカル ケア 医療
- 緩和ケア
- 質的研究合成
背景:
- 集中治療室 (ICU) の緩和ケアへの統合は 独特の課題を提示しています
- 医療提供者,患者,家族の視点を理解することは 効果的な実施に不可欠です.
研究 の 目的:
- ICUでの緩和ケアに関する経験と認識に関する質的証拠をまとめます.
- 集中治療室での緩和医療の提供に影響を与える障壁や促進要因を特定する.
主な方法:
- 定性的な研究のメタアグリゲーションが行われました.
- 多数のデータベースを介して広範な文献検索が行われました.
- データを抽出し,ジョアンナ・ブリッグス研究所 (JBI) のツールを使用して評価し,その後メタアグリゲーションを行いました.
主要な成果:
- 31の定性研究が含まれて,534の結果が出た.
- 結果は10のテーマに分類され,5つの主要分野にまとめられました. 感情管理,コミュニケーション,ケアモデル,環境要因/資源,教育です.
- 結論の信頼性は"明瞭"または"信頼性"の評価を用いて評価された.
結論:
- ICUでの緩和ケアには,感情管理,コミュニケーション,ケアモデル,リソースの利用可能性,およびスタッフの教育が大きく影響します.
- 推奨事項には,多学科のチームワークの強化,感情的およびコミュニケーションのサポートの強化,リソースの最適化,標的型トレーニングの提供が含まれています.
- 将来の研究は,様々なICU環境に合わせた緩和ケア戦略に重点を置くべきです.
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