Aims
To explore the palliative care experiences of forced migrant children, families, and healthcare professionals (HCPs) highlighting successes, challenges, and associated practice implications.
Design
Systematic literature review.
Data Sources
The following search engines were searched from 2008 ‐ 2018: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health, MEDLINE, Embase, ProQuest, Scopus, Psycinfo, and Web of Science. Extensive reference and citation checking were also conducted.
Review Methods
Systematic review followed PRISMA guidelines with prepared PROSPERO registered protocol #CRD42019129200. English language qualitative, quantitative, or mixed methods studies were eligible for inclusion. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT).
Results
Eighteen studies (reported in 20 articles) met the final inclusion criteria. Most focused on challenges to care provision. Thematic analysis following methods proposed by Braun and Clarke was undertaken. Five themes were identified: (a) divergence of beliefs and expectations; (b) communication; (c) navigating healthcare systems; (d) burdens and coping strategies; and (e) training and knowledge. A compassionate, collaborative approach with mutual respect crossed themes and was linked to high‐quality care.
Conclusion
Forced migrant families have multiple needs including physical and emotional support and help in navigating complex systems. Professional interpreters can ease communication barriers when resourced appropriately. Individualized care is crucial to addressing the intricate mosaic of culture such families present. A cultural sensitivity/insensitivity framework is presented that may help guide future interactions and priorities for those working in children's palliative care.
Impact
This systematic review explored the international experiences of palliative care for forced migrant families. The findings highlight the plight of families who experience multiple traumas and increased levels of grief and loss through their migration experiences and when caring for a child with a life‐limiting condition. This research has potential to have an impact on professionals working with culturally diverse families in all palliative care settings.
目標
探討被迫移民兒童、家庭和醫療專業人員(HCP)的姑息治療經驗,強調成功、挑戰和相關實踐意義。
設計
系統文獻回顧。
數據來源
搜索2008年至2018年以下搜尋引擎中的內容:英國聯合補充醫學資料庫、CINAHL護理學全文權威資料庫、聯機醫學文獻分析和檢索系統(MEDLINE),荷蘭醫學文摘資料庫(Embase)、ProQuest學位論文文摘索引資料庫、Scopus電子資料庫、心理學文摘(PsycINFO)和科學網。此外,還進行了廣泛的參考文獻和引文檢查。
評審方法
系統回顧遵循PRISMA指南,編制PROSPERO註冊協議編號是CRD42019129200。入選標準為英語類的定性、定量或混合方法研究。採用混合方法評價工具(MMAT)評價研究的質量。
結果
18篇研究(報告的有20篇)符合最終入選標準。最關注的是護理法規方面的挑戰。採用布勞恩和克拉克提出的方法進行專題分析。確定了五大主題:(a) 信念和期望的分歧;(b)溝通;(c)醫療體系導航;(d)負擔和應對策略;以及(e)培訓和知識。依託跨主題的相互尊重的富有同情心的協作方式,與高質量的護理相聯繫。
結論
被迫移民家庭有多種需求,包括身體和精神上的支持,以及對於複雜體系導航的幫助。如果資源充足,專業口譯員可以緩解溝通上存在的障礙。個性化護理對於解決這些家庭所呈現的複雜多元文化至關重要。提出一個文化敏感性/不敏感性的框架,可能有助於對從事兒童姑息治療人員在其今後互動和工作要務方面給予指導。
影響
本系統回顧探討了國際上對被迫移民家庭進行姑息治療的經驗。研究發現強調那些經歷了多重創傷的家庭困境,在他們移民的經歷中,以及在照顧重症患者兒童時,他們的悲傷和失落程度有所增加。該研究有可能對在所有姑息治療環境中與多樣文化家庭合作的專業人士產生影響。