医护人员对实施心肺复苏时家属在场态度与体验的Meta整合

Attitudes and experiences of medical staff regarding the presence of family members during the administration of CPR:a Meta synthesis

目的整合医护人员对实施心肺复苏时家属在场的态度与体验,为我国开展心肺复苏时家属在场临床实践提供参考。方法检索PubMed、Embase、Web of Science、the Cochrane Library、CINAHL、中国知网(CNKI)、万方数据库、中国生物医学文献数据库(CBM)自建库至2022年8月收录的有关医护人员对心肺复苏时家属在场态度与体验的质性研究。采用澳大利亚JBI循证卫生保健中心(2017)质性研究质量评价标准评价文献质量,采用汇集性整合方法进行整合。结果共纳入12篇文献,提炼出74个研究结果,归纳形成10个新类别,4个整合结果。4个整合结果分别是医护人员对心肺复苏时家属在场的态度及原因、心肺复苏时家属在场对复苏团队的影响、心肺复苏时家属在场对患者及家属的影响、医护人员允许心肺复苏时家属在场的现实困境与建议。结论应重视医护人员实施心肺复苏时允许家属在场面临的诸多困难与需求,结合我国医疗背景,从医院管理、临床实践、患者及家属需求等多层面考量,完善我国医院人文关怀体系,提升医护人员实施心肺复苏时家属在场的可及性。

Objective To systematically integrate the attitudes and experiences of medical staffs towards the family presence during resuscitation and provide a reference for the development of family presence during resuscitation clinical practice in China.Methods To search PubMed,Embase,Web of Science,The Cochrane Library,CINAHL,CNKI,CBM and Wanfang database for qualitative studies on medical staff's attitudes and experiences of family presence during resuscitation since its inception to August 2022.The quality of the literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care(2017)quality assessment criteria for qualitative studies,which were integrated using a pooled integration approach.Results A total of 12 papers were included to distil the findings of 74 studies,which were summarized to form 10 new categories and 4 consolidated findings including medical staffs′attitudes towards and reasons for family presence during resuscitation,the impact of family presence during resuscitation on the resuscitation team,the impact of family presence during resuscitation on patients and families,and the real-life dilemmas and recommendations for medical staffs to allow family presence during resuscitation.Conclusions We should pay attention to the difficulties and needs of family presence during resuscitation by medical staff,take into account the medical context in China,and improve the humanistic care system in our hospitals by considering hospital management,clinical practice,and the demands of patients and their families,in order to improve the accessibility of family presence during resuscitation by the medical staff.