以家庭为中心的照护模式在成人ICU患者中应用的范围综述

Application of the family-centered care model in adult ICU patients: a scoping review

目的了解以家庭为中心的照护模式在成人ICU患者中的应用现状,为今后开展相关干预研究提供参考依据。方法参照《范围综述报告规范(2018)》,检索PubMed、Cochrane Library、Web of Science、Embase、CINAHL、中国知网、维普网、万方数据库和中国生物医学文献数据库中有关以家庭为中心的照护在成人ICU患者中应用的研究。检索时限为建库至2021年12月31日。对纳入的文献进行整合性分析。结果共纳入16篇文献。整合分析结果显示,以家庭为中心的照护模式应用形式包括以家庭为中心的查房、跨学科家庭会议、弹性家庭探视和陪伴、家庭参与重症照护、家属参与终末期重症患者姑息照护5个方面;干预内容包括为医护提供培训和课程教育、医护为家属提供信息和照护技能指导、对家属的决策支持、对家属的心理支持4个方面。结论在成人ICU患者中实施以家庭为中心的照护模式具有可行性,应用效果较好。有关部门应根据我国国情制订相应的管理机制和激励制度,丰富干预形式,以促进以家庭为中心的照护模式在成人ICU患者中推广应用。

Objective To explore the application of family-centered care model in adult(Intensive Care Unit)ICU patients,so as to provide a reference for future intervention research.Methods Referring to"Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews(2018)",research on the application of family-centered care in adult ICU patients was retrieved in PubMed,Cochrane Library,Web of Science,Embase,CINAHL,China National Knowledge Infrastructure(CNKI),VIP,WanFang Data,and China Biomedical Literature Database.The retrieval time limit was from the establishment of the database to December 31,2021.An integrated analysis of the included articles was performed.Results A total of 16 articles were included.The integrated analysis showed that the application forms of the family-centered care model consisted of five aspects,namely,family-centered rounds,interdisciplinary family meetings,flexible family visitation and companionship,family participation in critical care,and family participation in palliative nursing for terminally ill critically ill patients.The interventions involved four aspects of providing training and course education for medical and nursing staff,providing information and care skill guidance for family members,decision support for family members,and psychological support for family members.Conclusions It is feasible and effective to implement a family-centered care model in adult ICU patients.Relevant departments should formulate corresponding management mechanisms and incentive systems in light of my country's national conditions,and enrich the forms of intervention,so as to promote the application of the family-centered care model among adult ICU patients.