生命末期成人住院患者护理评估的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.13.006

摘要/Abstract

摘要：

目的检索、评价并汇总生命末期成人住院患者护理评估的最佳证据，为护理实践提供循证支持。方法系统检索BMJ Best Practice、UpToDate、国际指南网、英国国家卫生与临床优化研究所网站、苏格兰院际指南网、医脉通指南网、加拿大安大略注册护士协会网站、美国国家综合癌症网、欧洲肿瘤内科学会网站、美国临床肿瘤学会网站、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library、PubMed、Embase、CINAHL、Web of Science、中国生物医学文献数据库、中国知网、万方数据服务平台和维普数据库，获取与生命末期成人住院患者护理评估相关的临床决策、指南、专家共识、证据总结、系统评价、Meta分析，检索时限为建库至2022年7月。由2名研究者独立进行文献质量评价、证据审校与提取，并经循证研究小组讨论后整合证据。结果共纳入13篇文献，其中临床决策3篇、指南6篇、专家共识2篇、系统评价2篇。从评估的重要性、评估实施人员、适用人群、评估时机、评估内容、评估工具、评估注意事项7个方面汇总22条证据。结论该研究总结了生命末期成人住院患者护理评估的最佳证据，建议护理人员在应用和转化证据时，充分考虑临床实际情况，探索具有本土特色的生命末期成人住院患者护理评估方案。

关键词: 生命末期, 安宁疗护, 住院, 护理评估, 证据总结, 循证护理学

Abstract:

Objective To search，evaluate and summarize the best evidence of comprehensive nursing assessment of adults hospitalised at the end of life，and to provide a reference for clinical nurses to carry out evidence-based practice. Methods We searched BMJ Best Practice，UpToDate，Guidelines International Network，National Institute for Clinical Excellence，Scottish Intercollegiate Guidelines Network，Yimaitong，Registered Nurses’ Association of Ontario，National Comprehensive Cancer Network，European Society for Medical Oncology，American Society of Clinical Oncology，Joanna Briggs Institute，Cochrane Library，PubMed，Embase，CINAHL，Web of Science，CBM，CNKI，Wanfang and CQVIP Database to collect all evidence about the comprehensive nursing assessment of adults hospitalised at the end of life. The search time limit is from the establishment of the databases to July，2022. There were 2 researchers who assessed the quality of the literature，reviewed and extracted the evidence，and integrated the evidence after discussion by the evidence-based research group. Results Totally 13 articles were involved，including 3 clinical decision supports，6 guidelines，2 expert consensuses and 2 systematic reviews. Finally，22 pieces of best evidence have been obtained from 7 aspects，including the importance of assessment，assessment implementation personnel，applicable population，assessment timing，assessment contents，assessment tools，assessment tips. Conclusion This study summarizes the best evidence of comprehensive nursing assessment of adults hospitalised at the end of life. It is recommended that nurses should fully consider the clinical situation when applying and transforming the evidence，and explore and carry out the program and practice of comprehensive nursing assessment for adults hospitalised at the end of life with Chinese characteristics.

Key words: End-of-Life, Palliative Care, Hospitalization, Nursing Assessment, Evidence Summary, Evidence-Based Nursing

郭俊晨, 龚有文, 戴云云, 成琴琴, 谌永毅. 生命末期成人住院患者护理评估的最佳证据总结[J]. 中华护理杂志, 2023, 58(13): 1571-1578.

GUO Junchen, GONG Youwen, DAI Yunyun, CHENG Qinqin, CHEN Yongyi. Summary of best evidence for comprehensive nursing assessment of adults hospitalised at the end of life[J]. Chinese Journal of Nursing, 2023, 58(13): 1571-1578.

图/表 5

图1 PubMed的文献检索策略

Figure 1 Literature search strategy of PubMed

图2 文献筛选流程图

Figure 2 Flow chart of literature screening

表1 纳入文献的基本特征（n=13）

Table 1 Sources and general characteristics of the included literature（n=13）

表2 纳入指南的质量评价结果（n=6）

Table 2 Quality assessment of included guidelines（n=6）

表3 生命末期成人住院患者护理评估的最佳证据汇总

Table 3 Evidence summary for the comprehensive nursing assessment in end-of-life adult inpatients

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