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首页> 外文期刊>Palliative medicine >Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
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Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence

机译：医疗保健专业人员与接近寿命终生患者亲属之间的沟通：对定性证据进行系统审查

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Background: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a 'good death'. To improve communication, it is important to first identify how this is currently being accomplished. Aim: To review qualitative evidence concerning characteristics of communication about prognosis and end-of-life care between healthcare professionals and relatives of patients approaching the end-of-life. Design: Qualitative systematic review (PROSPERO registration CRD42017065560) using thematic synthesis. Peer-reviewed, English language articles exploring the content of conversations and how participants communicated were included. No date restrictions were applied. Quality of included studies was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data sources: An electronic database search of CINAHL, MEDLINE, PsycINFO and EMBASE was performed. Results: Thirty-one papers were included. Seven themes were identified: highlighting deterioration; involvement in decision-making, post-decision interactional work, tailoring, honesty and clarity, specific techniques for information delivery and roles of different healthcare professionals. Varied levels of family involvement in decision-making were reported. Healthcare professionals used strategies to aid understanding and collaborative decision-making, such as highlighting the patient's deterioration, referring to patient wishes and tailoring information delivery. Doctors were regarded as responsible for discussing prognosis and decision-making, and nurses for providing individualized care. Conclusion: Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals.
机译：背景：医疗保健专业人员与接近生命结束的患者亲属之间的有效沟通至关重要，以确保患者有“良好的死亡”。为了改善沟通，重要的是首先识别目前正在实现的。目的：审查医疗保健专业人士与接近生活终生患者亲属之间的预后和生活终止关联的特征的定性证据。设计：定性系统评价（Prospero注册CRD42017065560）使用主题合成。同行评审，探索对话内容以及包括参与者的沟通的内容。没有应用日期限制。使用Joanna Briggs Institute批判性检查清单进行了定性研究，评估了所包含的研究。数据来源：进行CINAHL，MEDLINE，PSYCINFO和EMBASE的电子数据库搜索。结果：包括三十一篇论文。确定了七个主题：突出劣化;参与决策，后期互动工作，定制，诚实和清晰度，信息传递的具体技术以及不同医疗保健专业人员的作用。报道了各种家庭参与决策的各级。医疗保健专业人士使用策略来帮助理解和协作决策，例如突出患者的恶化，指的是患者愿望和裁缝信息交付。医生被视为负责讨论预后和决策，以及提供个性化护理的护士。结论：调查结果表明培训可以提供具有这些策略的医疗保健专业人员来改善沟通。问题提示列表等干预措施可以帮助亲属克服参与决策的障碍。需要进一步的研究来了解不同环境中的亲属和不同的医疗保健专业人员的沟通。

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