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End-of-life care in acute hospitals: an integrative literature review

机译：急性医院的临终关怀：综合文献综述

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End-of-life care in acute hospitals: an integrative literature review Aim. To explore and define the current status of published literature related to end-of-life care in the acute hospital setting. Background. Chronic illness is now the leading cause of death in developed countries because the population is and the advances in health care delivery. In Australia, two-third of people with chronic illness who die is inpatient in an acute hospital. Whilst most of the attention regarding end-of-life care and dying has focused on palliative care settings, there is a need to consider those dying outside of specialist palliative care settings. Design. Integrative literature review. Methods. Using an integrative approach, electronic searches of selected databases were undertaken, using comprehensive search terms. Secondary sources were also identified through the reference lists of retrieved literature. Results. The literature review identified a lack of high-quality scientific evidence to direct end-of-life care as delivered in the acute (non-palliative care) sector. From the literature available, five core themes/issues were generated to reflect the literature. Conclusions. There is a need for research to investigate end-of-life care in the acute hospital setting. Care pathways are in use to varying degrees without validation, but implementation alone does not ensure quality end-of-life care. Cultural factors can impede/impact practice and the ability of clinicians to recognise 'active dying' has been shown to be problematic, delaying the transition to end-of-life care. Relevance to clinical practice. Given that the majority of deaths in Australia occur in acute hospital settings, clinicians should be delivering expert life-sustaining acute care and also quality end-of-life care.
机译：急性医院的临终关怀：综合性文献综述目的。在急性医院环境中探索和定义与寿命终止护理有关的已出版文献的当前状态。背景。现在，慢性病已成为发达国家的主要死亡原因，因为人口和医疗保健水平不断提高。在澳大利亚，三分之二的死于慢性病的人在一家急诊医院住院。尽管有关临终护理和死亡的大多数注意力都集中在姑息治疗场所，但有必要考虑那些在专业姑息治疗场所之外死亡的人。设计。综合文献综述。方法。使用综合方法，使用综合搜索词对选定数据库进行电子搜索。还通过检索文献的参考清单确定了二级来源。结果。文献综述指出，缺乏直接（如非急性治疗）部门提供的指导生命终期护理的高质量科学证据。从现有文献中，产生了五个核心主题/问题以反映文献。结论。需要进行研究以调查急性医院环境中的临终护理。未经验证，护理途径在不同程度上得到了使用，但是仅实施一项措施并不能确保高质量的临终护理。文化因素可能会阻碍/影响实践，并且临床医生认识到“主动死亡”的能力已显示出问题，从而延缓了向临终护理的过渡。与临床实践有关。鉴于澳大利亚的死亡多数发生在急诊医院，因此临床医生应提供维持生命的专家急诊以及优质的临终护理。

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