晚期癌症患者心理痛苦的安宁疗护管理最佳证据总结

护理学杂志2023年4月第38卷第7期·75*·心理护理·晚期癌症患者心理痛苦的安宁疗护管理最佳证据总结张璐，伍晓琴1，黄月霖12，陈佳增，杨婷，傅静摘要：目的检索并总结晚期痛症患者心理痛苦的安宁疗护管理最佳证据，为临床干预提供循证依据。方法系统检索UpToDate、BMJ Best Practice,Cochrane Library、国际指南协作网，美国国家临终关怀及姑息治疗联盟，PubMed,中国知网，万方数据库中与晚期璃症患者心理痛苦的安宁疗护管理有关的所有证据，检索时限为2010年1月至2022年11月。由2名研究者独立对文献质量进行评价及证据提取，与循证小组共同进行证据核对及整合。结果纳入20篇文献，包含8篇指南、2篇临床决策、1篇推荐实、2篇证据总结、4篇系统评价、3篇随机对照试验。从管理原则、塘查与评估、介入管理的时机、环境管理、药物干预、非药物干预，健康教育，培训与保障8个方面总结24条最佳证据，结论晚期痛症患者心理痛苦的安宁疗护管理最佳证据可为医护人员开展晚期癌症惑者心理痛苦预防和护理提供循证依据，临床应用时，需结合实际情况、充分考虑惠者及家属的需求和意愿，制订科学的、个体化的心理痛苦管理方案，以提高晚期癌症惠者生活质量，关键词：晚期痛症：心理痛苦：安宁疗护：临终关怀：姑息治疗：证据总结：循证护理中图分类号：R473.73:B849D0I:10.3870/j.issn.1001-4152.2023.07.075Best evidence summary for palliative management of psychological distress in patients with advanced cancer Zhang Lu,Wu Xiaogin,Huang Yuelin,Chen Jiazeng,Yang Ting,Fu Jing.School of Nursing,Southwest Medical University,Luzhou 646000,Chi-naAbstract:Objective To search for and summarize the best evidence on palliative management of psychological distress in patientswith advanced cancer,and to provide evidence-based evidence for clinical intervention.Methods The publications published duringJanuary 2010 to November 2022 on palliative management of psychological distress in patients with advanced cancer,were retrievedfrom UpToDate,BMJ Best Practice,Cochrane Library,International Guideline Collaboration,National Hospice and PalliativeCare Alliance,PubMed,CNKI,Wanfang Data,ete.Two reviewers independently evaluated the quality of the literature and extrac-ted evidence,and worked in partnership with an evidence-based team to check and integrate the evidence.Results Twenty publica-tions were included:8 guidelines,2 clinical decision reports,1 best practice report,2 evidence summary reports,4 systematic re-views,and 3 randomized controlled trials.The best evidence was summarized into 8 aspects totaling 24 pieces of evidence:manage-ment principles,screening and evaluation,timing of interventional management,environmental management,pharmacological in-tervention,non-pharmacological intervention,health education,and training and guarantee.Conclusion The summarized best evi-dence of palliative care management of psychological distress in patients with advanced cancer,can provide an evidence-based basisfor medical workers to take preventive measures or provide care for psychological distress in this population.In clinical application.it is necessary to conform to the actual clinical situation and fully consider the needs and wishes of patients and their families to for-mulate scientific and individualized psychological distress management programs,in an effort to improve the quality of life of endstage cancer patients.Key words:advanced cancer:psychological distress:palliative care:end-of-life care:hospice care:evidence summary:evidence-based nursing据国际癌症研究机构数据)显示，2020年中国tional Comprehensive Cancer Network,NCCN)癌症死亡病例300万例，位居全球癌症死亡病例数首症相关性心理痛苦定义为)：一种心理（认知、行为及位。癌症现已成为中国人群的主要死亡原因之一四情感)、社会、精神和（或）身体等多种因素引起的不愉随着病情的恶化，晚期癌症患者要承受严重的疾病症快体验，会干扰患者有效应对癌症、身体症状及治疗