基于Web of Science 2004—2020年国内外ICU安宁疗护研究热点分析与启示

doi:10.16460/j.issn1008-9969.2021.21.031

摘要/Abstract

摘要： 目的对国内外ICU安宁疗护领域研究热点进行总结,了解其发展现状和趋势。方法以Web of Science数据库为基础,以hospice、“terminal care”、“intensive care”等为主题词,检索2004—2020年的ICU安宁疗护相关文献,导入书目共现分析系统（BICOMB2.0）,进行高频关键词的提取,形成词篇矩阵,使用gCLUTO 1.0软件对词篇矩阵进行聚类分析。结果纳入有效文献1 274篇,截取高频关键词41个,聚类分析得出6个热点,归为3个方向：（1）不同疾病和年龄群的安宁疗护;（2）ICU安宁疗护实施的重点环节,包括预立计划、安宁疗护早期咨询、家庭会议和多学科协作、维持/撤出治疗等;（3）ICU安宁疗护实践中的阻碍因素,如伦理和道德压力、传统文化因素、ICU医护人员对安宁疗护的认知及知识储备等。结论西方的ICU安宁疗护在研究对象、服务流程、从业者认知、相关社会背景研究等方面有较多经验,我国正在探索和发展适应国情的安宁疗护模式。建议可借鉴成熟经验,通过多途径来实现发展,包括：多学科ICU团队参与安宁疗护;对大众传播和普及相关理念;加强医护人员的教育和培训;院校开设必修课程;出台相应的法律法规和伦理要求,规范安宁疗护准入和管理标准等。

关键词: ICU, 安宁疗护, 护理, 研究热点, 聚类分析

Abstract: Objective To summarize the research hotspots in the field of hospice care in ICU at home and abroad, and to understand its current status and trends.Methods Based on the Web of Science, we searched literature with "hospice","terminal care","intensive care" and other subject terms. The Bibliographic Item Co-Occurrence Matrix Builder (BICOMB2.0) was used to extract high frequently keywords and the gCLUTO1.0 software was used to cluster the discourse matrixes.Results A total of 1,274 valid articles were included and 41 high-frequency keywords were intercepted. Six hotspots were obtained by cluster analysis, which were classified into 3 directions:(1) hospice care for patients with different diseases and age;(2) essentials in hospice care included planning,consultation in the early stage,family meeting and multidisciplinary collaboration and maintenance and withdrawal of the treatment; (3) barriers in hospice care, e.g. religious, cultural and ethical issues. Conclusion There is more experience in western countries in research objects, service processes, practitioners' cognitions, and related social backgrounds about palliative care in ICU. Models that adapt to our national conditions need to be explored. It is recommended to learn such experience and development through multiple channels including: multidisciplinary ICU team collaborations; popularization of related concepts; more education and training of medical staff; compulsory courses in universities and colleges;corresponding laws and regulations and ethical requirements,standardization of the access and management standards of hospice care.

Key words: intensive care, hospice care, nursing, research hotspot, cluster analysis

中图分类号:

徐艳, 袁玲. 基于Web of Science 2004—2020年国内外ICU安宁疗护研究热点分析与启示[J]. 护理学报, 2021, 28(21): 31-35.

XU Yan, YUAN Ling. Research Hotspots of Hospice Care in ICU Based on Web of Science from 2004 to 2020 and Its Enlightenment[J]. Journal of Nursing, 2021, 28(21): 31-35.

参考文献

[1] Hu K,Feng D.Barriers in Palliative Care in China[J].Lancet, 2016, 387(10025):1272-1272. DOI:10.1016/s0140-6736(16)30017-4.
[2] 崔雷,刘伟,闫雷,等.文献数据库中书目信息共现挖掘系统的开发[J].现代图书情报技术,2008(8):70-75.DOI:10.3969/j.issn.1003-3513.2008.08.013.
[3] Ma J, Chi S, Buettner B, et al.Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial[J].Crit Care Med,2019,47(12):1707-1715.DOI:10.1097/ccm.0000000000004016.
[4] Fokin AA, Wycech J, Katz JK, et al.Palliative Care Consultations in Trauma Patients and Role of Do-not-resuscitate Orders: Propensity-matched Study[J]. Am J Hosp Palliat Med,2020,37(12):1068-1075.DOI:10.1177/1049909120919672.
[5] Hung YS, Chang H, Wu WS, et al.A Comparison of Cancer and Noncancer Patients Who Receive Palliative Care Consultation Services[J].Am J Hosp Palliat Med, 2013,30(6): 558-565. DOI:10.1177/1049909112461842.
[6] Bar B, Creutzfeldt CJ, Rubin MA.Palliative Care in the Neuro-ICU: Perceptions, Practice Patterns, and Preferences of Neurointensivists[J]. Neurocrit Care,2020,32(1):302-305. DOI:10.1007/s12028-019-00838-w.
[7] Lele A, Cheever C, Healey L, et al.Operationalization of the Transition to Comfort Measures Only in the Neurocritical Care Unit: A Quality Improvement Project[J]. Am J Hosp Palliat Med,2019, 36(1):38-44.DOI:10.1177/1049909118790069.
[8] Mesukko J, Turale S, Jintrawet U, et al.Palliative Care Guidelines for Physicians and Nurses Caring for Children and Their Families in the Pediatric Intensive Care Units: A Participatory Action Research Study[J]. Pac Rim Int J Nurs Res,2020,24(2):202-218.
[9] Currie ER, Christian BJ, Hinds PS, et al.Parent Perspectives of Neonatal Intensive Care at the End-of-life[J]. J Pediatr Nurs,2016,31(5):478-489.DOI:10.1016/j.pedn.2016.03.023.
[10] Lam V, Kain N, Joynt C, et al.A Descriptive Report of End-of-life Care Practices Occurring in Two Neonatal Intensive Care Units[J]. Palliat Med,2016,30(10):971-978. DOI:10.1177/0269216316634246.
[11] Dombrecht L, Piette V, Deliens L,et al.Barriers to and Facilitators of End-of-life Decision Making by Neonatologists and Neonatal Nurses in Neonates: A Qualitative Study[J].J Pain Symptom Manage,2020,59(3):599-608. DOI:10.1016/j.jpainsymman.2019.10.007.
[12] Boyle DA, Barbour S, Anderson W, et al.Palliative Care Communication in the ICU: Implications for an Oncology-Critical Care Nursing Partnership[J]. Semin Oncol Nurs,2017,33(5):544-554. DOI:10.1016/j.soncn.2017.10.003.
[13] Mitchell S, Spry JL, Hill E, et al.Parental Experiences of End of Life Care Decision-making for Children with Life-Limiting Conditions in the Paediatric Intensive Care Unit: A Qualitative Interview Study[J]. BMJ Open, 2019, 9(5):e028548. DOI:10.1136/bmjopen-2018-028548.
[14] Flannery L, Peters K, Ramjan LM.The Differing Perspectives of Doctors and Nurses in End-of-life Decisions in the Intensive Care Unit: A Qualitative Study[J].Aust Crit Care,2020,33(4):311-316.DOI:10.1016/j.aucc.2019.08.004.
[15] Azab SMS, Abdul-Rahman SA, Esmat IM.Survey of End-of-life Care in Intensive Care Units in Ain Shams University Hospitals, Cairo, Egypt[EB/OL].(2020-08-13)[2021-02-25].https://link.springer.com/content/pdf/10.1007/s10730-020-09423-7.pdf
[16] Heyland DK, Dodek P, Mehta S,et al.Admission of the Very Elderly to the Intensive Care Unit: Family Members' Perspectives on Clinical Decision-making from a Multicenter Cohort Study[J].Palliat Med,2015,29(4):324-335. DOI:10.1177/0269216314566060.
[17] Wang D, Ing C, Blinderman CD, et al.Latent Class Analysis of Specialized Palliative Care Needs in Adult Intensive Care Units from a Single Academic Medical Center[J]. J Pain Symptom Manage,2019,57(1):73-78.DOI:10.1016/j.jpainsymman.2018.10.270.
[18] Cinnella G, Lo Presti C.Perspectives Concerning the Law on Advance Directives and Advance Care Planning and their Effects on End-of-life Care in Italian Intensive Care Units[J].Minerva Anestesiol,2019,85(4):338-341. DOI:10.23736/s0375-9393.19.13540-7.
[19] Coelho CBT, Yankaskas JR.New Concepts in Palliative Care in the Intensive Care Unit[J]. Rev Brasi Ter Intensiva,2017,29(2):222-230.DOI:10.5935/0103-507x.20170031.
[20] 申靓亮,刘冰冰,赵利梅,等.我国台湾安宁疗护的发展历程及启示[J].护理管理杂志,2017,17(3):189-191. DOI:10.3969/j.issn.1671-315X.2017.03.013.
[21] (原)国家卫生和计划生育委员会.安宁疗护中心基本标准和管理规范(试行)[J].中国护理管理,2017,17(3):289-290. DOI:10.3969/j.issn.1672-1756.2017.03.001.
[22] Koff G, Vaid U, Len E, et al.Differences in Utilization of Life Support and End-of-life Care for Medical ICU Patients with Versus without Cancer[J]. Crit Care Med,2017,45(4): E379-E383.DOI:10.1097/ccm.0000000000002260.
[23] Cox CE, Curtis JR.Using Technology to Create a More Humanistic Approach to Integrating Palliative Care into the Intensive Care Unit[J]. Am J Respir Crit Care Med,2016,193(3):242-250.DOI:10.1164/rccm.201508-1628CP.
[24] Bodnar J.Terminal Withdrawal of Mechanical Ventilation: A Hospice Perspective for the Intensivist[J]. J Intensive Care Med,2019,34(2):156-164.DOI:10.1177/0885066618797918.

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