目的:本研究旨在评价和分析已发表的围产期丧亲护理临床实践指南(CPGs)的方法学质量,为实施最佳临床实践提供参考。
方法:我们在五个电子数据库(PubMed,科克伦图书馆,WebofScience,CNKI,万方数据库),八个指南数据库,和专业机构的六个网站,从2021年3月到2021年6月。四名研究人员使用《研究与评估指南》(AGREEII)工具对选定的CPG进行了独立评估。AGREEII域的评分者间可靠性是使用具有95%CI的组内相关系数计算的。
结果:我们共纳入了8个CPG。六个领域的平均得分范围从最低得分46.61%(编辑独立性)到最高得分87.85%(呈现清晰度)。亚组分析显示无统计学差异。每个域都实现了“良好”和“非常好”的组内可靠性。两个CPG被认为是A级(强烈建议),五个被评为B级(建议修改),一个被评估为C级(不推荐)。
结论:产科和新生儿科的医疗专业人员在帮助失去亲人的父母和家庭应对围产期损失方面发挥着重要作用。围产期丧亲护理的高质量CPG可以作为提高临床实践质量和结果的有用资源。应作出更多努力,传播围产期丧亲护理的最佳做法。在不同背景的国家或地区实施GCP时,专业翻译,严格验证,应该考虑到文化适应。
OBJECTIVE: This study aimed to evaluate and analyze the methodological quality of the published clinical practice
guidelines (CPGs) for perinatal bereavement care and provide a reference for implementing best clinical practices.
METHODS: We performed a systematic and comprehensive search in five electronic databases (PubMed, The Cochrane Library, Web of Science, CNKI, Wan Fang Database), eight
guideline databases, and six websites of professional organizations from March 2021 to June 2021. Four researchers used the Appraisal of
Guidelines for Research and Evaluation (AGREE II) instrument to appraise the selected CPGs independently. The inter-rater reliability of AGREE II domains was calculated using the intraclass correlation coefficient with 95% CI.
RESULTS: We included a total of 8 CPGs. The mean scores of six domains ranged from the lowest score of 46.61% (editorial independence) to the highest score of 87.85% (clarity of presentation). Subgroup analysis showed no statistical difference. Each domain achieved \"good\" and \"very good\" intraclass reliability. Two CPGs were deemed as grade A (strongly recommended), five were rated as grade B (recommended with modifications), and one was evaluated as grade C (not recommended).
CONCLUSIONS: Healthcare professionals in obstetrics and neonatology play an important role in helping bereaved parents and families to cope with perinatal loss. High-quality CPGs for perinatal bereavement care can serve as useful resources to improve the quality and outcomes of clinical practice. More efforts should be made to disseminate the best practices for perinatal bereavement care. When implementing GCPs in countries or regions with different backgrounds, professional translations, strict validations, and cultural adaptations should be taken into account.