以患者-家庭为中心照护模式在成人ICU应用的最佳证据总结

Summary of the best evidence of patient-and family-centered care in adult ICUs

目的检索、筛选和评价以患者—家庭为中心照护模式在成人ICU应用的相关证据,并形成最佳证据总结,为临床实践提供参考。方法按照“6s”证据模型检索国内外计算机决策支持系统、指南网、数据库及相关学会网站,纳入的文献类型包括临床决策、最佳实践、指南、证据总结、系统评价和专家共识,检索时限为建库至2023年6月14日。由2名研究者对文献进行筛选、质量评价和资料提取,由研究团队对证据归类整合。结果最终纳入13篇文献,其中临床决策3篇、指南2篇、系统评价7篇、专家共识1篇。从改善环境、医护与家属举行沟通会、增加家属陪伴、提高对家属的支持度、为患者提供舒缓治疗、提供延续性护理6个方面共总结24条最佳证据。结论该研究总结了以患者—家庭为中心照护模式在成人ICU应用的最佳证据,建议医护人员根据临床情境、患者和家庭情况制订个体化干预方案,改善ICU患者—家庭的结局。

Objective The evidence of patient-and family-centered care in the adult ICUs was retrieved,screened and evaluated,and the best evidence summary was formed,so as to provide references for clinical practice.Methods In accordance with the"6S"evidence model,domestic and international computerized decision support systems,guideline networks,databases,and websites of related societies were systematically searched,and the types of literature included clinical decisions,best practices,guidelines,evidence summaries,systematic reviews and expert consensuses,with a timeframe from the establishment of the database to June 14,2023.Two researchers screened the literature,assessed quality and extracted information,and the evidence was categorized and integrated by the research team.Results Thirteen publications were ultimately included,including three clinical decisions,two guidelines,seven systematic reviews and one consensus.A total of 24 pieces of best evidence with 6 dimensions were summarized,including improving the environment,holdingg communication meetings between healthcare providers and families,increasing family companionship,improving support for families,providing palliative care for patients and offering continuous care.Conclusion TThe best evidence summary of patient-and family-centered care in the adult ICUs was summarized in this study.It is recommended for ICU medical staff to formulate an individualized intervention protocol based on the clinical context,the patient and the family,so as to improve ICU patient-family outcomes.