护士参与生命终末期患者临终决策阻碍因素的Meta整合

Obstacles to nurses'participation in end-of-life decision-making of patients in the terminal-stage:a Meta-synthesis

目的:分析与评价护士参与终末期患者临终决策的阻碍因素,为改进临终决策工作模式提供参考。方法:计算机检索国内外数据库中关于护士参与患者临终决策影响因素的质性研究,检索时限为建库至2022年9月。选择澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献质量进行评价,采用汇集性整合方法对结果进行整合。结果:共纳入10篇文献,提炼出26个研究结果,归纳形成7个类别,合成临终决策能力、认知和态度、医疗环境3个整合结果。结论:阻碍护士参与终末期患者临终决策的因素较多,建议采取多样化决策辅助手段,给予医疗支持和人文关怀,帮助护士提高决策参与能力和信心,为推动我国临终服务体系发展提供可靠依据。

Objective:To analyze and evaluate the barriers of nurses'participation in end-of-life decision-making for patients in the end-stage,so as to provide a reference for improving end-of-life decision-making mode.Methods:PubMed,Web of Science,PsycINFO,The Cochrane Library,Embase,Medline,CBM,CNKI,Wanfang and VIP databases were searched for qualitative studies on the influencing factors of nurses'participation in patients'end-of-life decision-making from the establishment of the database to September 2022.The quality of literature was evaluated by the qualitative research quality evaluation criteria of Australian JBI Evidence-based Health Care Center,and the results were integrated by the pooled integration method.Results:A total of 10 literatures were included,26 research results were extracted,7 categories were formed,and 3 integrated results,including end-of-life decision-making ability,cognition and attitude,medical environment were synthesized.Conclusion:There are many factors that prevent nurses from participating in end-of-life decision-making.It is suggested to adopt various decision-making in time,provide medical supports and humanistic care,help nurses improve their ability and confidence in decision-making,and provide a reliable basis for promoting the development of end-of-life service system in China.