即将死亡的高特异性临床体征：一项范围综述

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-01-30 DOI:10.1016/j.ijnurstu.2025.105015

Catarina Simões , Rui Carneiro , Abílio CardosoTeixeira

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引用次数: 0

摘要

在生命的最后几天和几个小时里，准确诊断即将到来的死亡对于提供适当的护理至关重要。立即认识到死亡情况，可以调整护理目标，确保它们符合患者的情况，同时调整团队和家属的期望。目的绘制和描述18岁以上癌症和非癌症住院患者即将死亡的高特异性临床体征的证据。方法根据乔安娜布里格斯研究所的范围审查方法，对已发表的文献进行全面检索。在线数据库包括MEDLINE、CINAHL complete、SCOPUS、WEB OF SCIENCE和Cochrane系统评价数据库，未发表研究的搜索包括OpenGrey、dat - europe和RCAAP。包括英语、法语、葡萄牙语和西班牙语的出版物，没有设定期间。系统评价的首选报告项目和扩展到范围评价指南的荟萃分析被用于报告结果。审查方案已在开放科学框架（Simões et al., 2022）中注册。结果本综述纳入的15项研究于2013年至2023年间以英文发表。除了确定即将死亡的临床症状外，一些研究人员打算为这种临床情况开发准确的预后模型。只有两项针对非癌症人群的研究符合纳入标准。12篇文章为前瞻性观察性研究（7篇为多中心研究），1篇为回顾性队列研究，2篇为叙述性综述。在这两个人群的研究中，一个共同的临床症状是呼吸伴下颌运动，特别是在生命的最后12小时。结论临近死亡的临床体征和预测模型可以帮助临床医生识别临近死亡。然而，它们不应该取代临床判断。需要进一步的研究来了解死亡过程是否在不同的患者群体和护理环境中有所不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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High specificity clinical signs of impending death: A scoping review

Background

Accurate diagnosis of impending death is essential to provide proper care in the last days and hours of life. Recognising the death situation immediately allows adjustment of care goals, ensuring that they suit the patient's condition, as well as tuning the team's and family's expectations.

Objective

To map and describe evidence on high specificity clinical signs of impending death in cancer and noncancer hospitalised patients over 18 years of age.

Methods

A comprehensive search of the published literature was conducted According to Joanna Briggs Institute's methodology for scoping reviews. Online databases, including MEDLINE, CINAHL complete, SCOPUS, WEB OF SCIENCE, and the Cochrane Database of Systematic Reviews, and the search for unpublished studies included OpenGrey, DART-Europe, and RCAAP. Publications in English, French, Portuguese, and Spanish were included, and no period was set. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extensions to scoping review guidelines were used to report the results. The review protocol was registered in Open Science Framework (Simões et al., 2022).

Results

The 15 studies included in this review were published in English between 2013 and 2023. In addition to identifying the clinical signs of impending death, some researchers intend to develop accurate prognostic models for this clinical situation. Only two studies in the noncancer population met the inclusion criteria. Twelve articles were prospective observational studies (seven were multicentre studies), one was a retrospective cohort study, and two were narrative reviews. A clinical sign that is common to studies in both populations is respiration with mandibular movement, particularly in the last 12 h of life.

Conclusions

Clinical signs of impending death and prediction models can help clinicians identify impending death. However, they should not replace clinical judgement. Further research is required to understand whether the dying process differs among different patient populations and care settings.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).