医疗复杂性的儿童是如何死亡的? 一个范围广泛的审查
Grace Mei Chan Ng1,2,3, Marie-Hélène Bourassa1,2, Hema Patel1,2
1Department of Pediatrics, McGill University Health Center, Montreal, Canada.
Journal of palliative medicine
|January 29, 2024
概括
对于患有医疗复杂性 (CMC) 的儿童的生命终端护理是很少理解的. 这篇综述综合了文献,揭示了高的医院死亡率和密集干预,强调了对同情护理的需求.
科学领域:
- 儿科 儿科 儿科
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 患有医疗复杂性 (CMC) 的儿童代表着日益增长的人口,死亡率不断增加.
- 对于CMC来说,生命周期末期的经验,轨迹和决策尚未得到充分理解.
- 现有的关于儿科生命终端护理的文献往往缺乏对CMC的关注.
研究的目的:
- 综合现有的关于患有医疗复杂性 (CMC) 的儿童生命末期经验的文献.
- 在生命末期的CMC中描述疾病轨迹,沟通和决策.
- 识别知识差距,并为未来的研究和临床实践提供信息.
主要方法:
- 在多个数据库 (MEDLINE,CINAHL,PsycINFO,Scopus,Embase,Google Scholar) 进行了全面的文献搜索,截至2021年8月26日.
- 包括报告生命结束时CMC的研究;提取的数据被描述性地分析.
- 从1535个出版物中确定了23项相关研究,其中大多数来自北美,于2015年后出版.
主要成果:
- 大多数CMC死亡 (80.6%) 发生在医院.
- 与非CMC相比,CMC体验了医疗保健利用率的增加和更密集的干预措施.
- 定性主题包括预后不确定性,不同的生活质量观点,父母的专业知识,终端事件的惊喜,多次损失,以及对同情护理的需求.
结论:
- 本范围审查强调了CMC生命终端护理的关键特征.
- 对于这一群体的生命终结体验,存在重大知识差距.
- 更好的理解对于为临床实践,服务开发和儿科息护理未来研究提供信息至关重要.
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