How to communicate with family members of the critically ill in the intensive care unit: A scoping review
How to communicate with family members of the critically ill in the intensive care unit: A scoping review
复制标题
如何与重症监护病房的重症患者家属沟通：范围界定审查
DOI：
10.1016/j.iccn.2022.103383
复制
发表时间：
2023
影响因子：
5.3
通讯作者：
Tsubaki Michihiro
中科院分区：
文献类型：
--
作者：
Ito Yoshiyasu;Tsubaki Michihiro
我们饶有兴趣地阅读了Reifarth等人最近发表的题为“如何与重症监护病房的危重病人家属沟通：范围审查”的文章。（2022年）。本研究绘制了目前的方法与患者家属的沟通，并提供了重要的意义，为未来的发展和实施的沟通路径在重症监护病房。然而，尽管Reifarth et al.（2022）建议采用一种结构化的跨专业框架，并采用基于移情沟通策略的标准化工具作为减少重症监护后综合征家庭（PICS-F）症状的沟通策略，这需要进一步讨论和考虑。在这里，我们提出了一个讨论这一考虑。Azoulay等人（2002）和Lautrette et al.（2007）讨论了结构沟通降低PICS-F风险的可能性。这一点从肯特-巴恩斯等人最近的一项研究结果中可以看出。（2022），其中发现移情和结构性沟通策略，特别是在生命结束时，可以降低PICS-F的风险。然而，也有证据表明，战略沟通并没有减少PICS-F的风险，如白色等人的研究。（2018年）。这些发现不同于Lautrette等人的证据。（2007）和Kentish-Barnes et al.（2022年），以及如何确切地解释这种差异？为了更好地理解这一点，我们需要定量地确定干预如何改变ICU中围绕家庭沟通的护理过程，正如白色等人所做的那样。（2018）认为这是他们研究的局限性。通过干预改变的家庭沟通过程如何影响家庭的认知评估（例如，对患者和家庭护理的满意度，对患者死亡的看法），以及如何降低PICS-F的风险也需要澄清。换句话说，在确定策略沟通可以降低PICS-F风险的机制方面存在研究空白。（2022）绘制了与重症监护室中的危重患者家属沟通的现有方法沿着相应的实施要求和益处。在本研究中，Reifarth et al.（2022）使用范围审查作为研究设计;然而，范围审查的主要目的是确定研究差距，我们的讨论提供了对与ICU家庭沟通期间发生的研究差距的进一步见解。
We read with interest the recently published article titled “How to communicate with family members of the critically ill in the intensive care unit: A scoping review” by Reifarth et al.(2022). This study mapped current approaches to communication with patient families and provided important implications for the future development and implementation of communication paths in intensive care units. However, while Reifarth et al.(2022) recommend a structured interprofessional framework with standardized tools based on empathic communication strategies as a communication strategy to decrease the symptoms of post-intensive care syndrome families (PICS-F), this needs further discussion and consideration. Here, we present a discussion of this consideration. Azoulay et al.(2002) and Lautrette et al.(2007) discussed the possibility of structural communication reducing the risk of PICS-F. This is evident from the results of a recent study by Kentish-Barnes et al.(2022), in which empathic and structural communication strategies, especially at the end of life, were found to reduce the risk of PICS-F. However, there is also evidence that strategic communication did not reduce the risk of PICS-F, as in the study by White et al.(2018). Such findings differ from the evidence of Lautrette et al.(2007) and Kentish-Barnes et al.(2022), and how exactly can such differences be explained? To better understand this, we need to quantitatively ascertain how the intervention changed care processes surrounding family communication in the ICU, as White et al.(2018) argued was a limitation of their study. How the processes surrounding family communication that were altered by the intervention affected the family's cognitive evaluations resulting from their ICU experience (eg, satisfaction with patient and family care, perceptions of patient death) and reduced the risk of PICS-F also needs to be clarified. In other words, there is a research gap in identifying the mechanisms through which strategic communication can reduce the risk of PICS-F.Undoubtedly, the study conducted by Reifarth et al.(2022) mapped the existing approaches to communication with critically ill family members in the intensive care unit along with corresponding implementation requirements and benefits. In the present study, Reifarth et al.(2022) used a scoping review as the study design; however, the primary purpose of a scoping review is to identify research gaps, and our discussion provides further insight into research gaps that occur during communication with families in the ICU.