在重症监护室实施息治疗:系统审查和将知识映射到实施研究逻辑模型中的知识
Stephanie A Meddick-Dyson1, Jason W Boland2, Mark Pearson2
1Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK. stephanie.meddick-dyson@nhs.net.
在重症监护室 (ICU) 实施息治疗 (PC) 需要解决资源和协作障碍. 本综述综合了指导有效ICU-PC干预设计和实施的证据.
科学领域:
- 实施科学 实施科学
- 息护理研究 息护理研究
- 密集护理医学 密集护理医学
背景情况:
- 息治疗 (PC) 在重症监护室 (ICU) 中至关重要,但其实施和整合存在挑战.
- 了解影响基于ICU的PC干预成功整合的因素至关重要.
研究的目的:
- 系统地审查和综合有关重症监护单位实施初级和/或专业息治疗干预措施的证据.
- 使用修改的实施研究逻辑模型 (IRLM) 来绘制实施因素,战略和结果.
主要方法:
- 通过主要的生物医学数据库 (MEDLINE,Embase,Cochrane,CINAHL,PsycINFO) 系统审查到2023年12月2日发表的研究.
- 包括与息治疗,重症监护和实施研究相关的术语.
- 应用适应的史密斯IRLM来分析实施决定因素,战略和机制.
主要成果:
- 包括84项研究,这些研究对ICU-PC的有效性有实质性的证据,但对实施因素的报道有所变化.
- 关键的促进因素包括足够的资源和PC-ICU团队合作;障碍包括资源限制,负面的PC感知和高的ICU敏度.
- 共同的实施策略包括资源审计,利益相关者合作,适应性干预,冠军和教育,以协作工作作为主要机制.
结论:
- 提供了设计,实施和评估ICU-PC干预措施的建议.
- 强调利益相关者的参与,ICU-PC合作,文化/资源评估,有针对性的战略,冠军,教育,以及对有效性和实施机制的强有力的数据收集.
- 强调实施结构和患者/家庭参与对于成功整合的重要性.
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