用于衡量新生儿姑息治疗和/或临终关怀在新生儿环境中的临床应用的结果:一项系统综述。

IF 3.9 2区 医学 Q1 PEDIATRICS
Katie Gallagher, Kathy Chant, Veronica Parisi, Mehali Patel, Helena Dunbar, Fauzia Paize, Sophie Bertaud, Agnes Agyepong, Alexandra Mancini, Myra Bluebond-Langner, Neil Marlow
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引用次数: 0

摘要

目的:新生儿姑息治疗和/或临终关怀结果的标准化报告将促进实践的比较,并导致更明智的实践决策。我们系统地回顾了目前用于评价新生儿环境中临床提供姑息治疗和/或临终关怀结果的证据。方法:采用Ovid Medline、Ovid Embase、Ovid PsycINFO、Ovid MIDIRIS和EBSCOhost CINAHL,按照系统评价和荟萃分析指南的首选报告项目进行系统评价。没有使用日期或语言限制。如果研究测量或报告了新生儿姑息治疗在新生儿病房的临床实践相关的结果,则纳入研究。结果:在数据库检索到的7998条记录中,共纳入20篇文献。确定的研究是回顾性的图表回顾。没有研究使用标准化结果,所有研究都使用代理结果测量。结果是根据世卫组织儿科姑息治疗领域组织的。所有研究(n=20)都报告了身体症状和功能状态(身体领域)的记录;六份记录在案的父母情感和支持需求(心理领域);四人报告兄弟姐妹的支持和更广泛的家庭存在(社会和文化领域),三人报告来自精神服务(精神领域)的支持。结论:尽管新生儿死亡占5岁以下儿童死亡的最大类别,但没有标准化的结局来描述或发展临床实践。制定新生儿姑息治疗和临终关怀的核心结果集将确保能够使用可靠收集和整理的数据对服务进行比较,并有助于推进这一领域的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes used to measure the clinical application of neonatal palliative and/or end-of-life care in neonatal settings: a systematic review.

Objectives: Standardised reporting of outcomes in neonatal palliative and/or end-of-life care would facilitate comparison of practice and lead to more informed decisions about practice. We systematically reviewed evidence evaluating outcomes currently used to characterise the clinical provision of palliative and/or end-of-life care in neonatal settings.

Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken using Ovid Medline, Ovid Embase, OVID PsycINFO, OVID MIDIRIS and EBSCOhost CINAHL. No date or language restrictions were used. Studies were included if they measured or reported outcomes related to the clinical practice of neonatal palliative care in a neonatal unit.

Results: Of 7998 records identified through database searching, 20 articles were included. Identified studies were retrospective chart reviews. No studies used standardised outcomes and all used proxy outcome measures. Results were organised according to the WHO domains of paediatric palliative care. All studies (n=20) reported documentation of physical symptoms and functional status (physical domain); six documented parental emotional and support needs (psychological domain); four reported sibling support and wider family presence (social and cultural domain), and three reported support from spiritual services (spiritual domain).

Conclusion: Despite neonatal death accounting for the largest category of child death under 5 years of age, there are no standardised outcomes from which to characterise or develop clinical practice. Developing a core outcome set for neonatal palliative and end-of-life care would ensure that services can be compared using reliably collected and collated data and help advance care in this area.

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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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