炎症性肠病患者自我管理体验质性研究的系统评价

Self-management experience of patients with inflammatory bowel disease:a systematic review of qualitative studies

目的整合相关质性研究,系统评价炎症性肠病患者自我管理过程中的体验。方法检索Pub Med、Embase、Science Direct、Web of Science、Psyc INFO以及中国生物医学数据库、万方、中国知网、维普数据库中从建库至2017年3月31日相关的质性研究。文章质量评价采用澳大利亚JBI循证卫生保健中心(2008)质性研究质量评价标准,采用汇集性整合的方法进行结果整合。结果共纳入6项研究,提炼35个完整的研究结果,归纳出9个新的类别,得到3个整合结果。(1)医疗管理:患者持续进行医疗行为调整和疾病知识积累,采取多元化的方式控制疾病,努力维持疾病缓解状态;(2)情绪管理:患者通过应对炎症性肠病带来的诸多压力和负性情绪,以积极的心态面对生活;(3)角色管理:患者不断进行认知、行为的调整来适应自己的患者角色,并努力维持生病前的日常生活角色。结论炎症性肠病患者自我管理涉及多个方面,情绪管理经常被忽视。护理人员应针对患者自我管理过程中的薄弱环节,给予指导和支持,帮助其更好地管理疾病。

Objective To conduct a systematic review on the experience of patients with inflammatory bowel disease （IBD） during self-management. Methods Five English （PubMed,Embase,Seience Direct,Web of Science, PsycINFO） and four Chinese （CBM,WANFANG,CNKI,VIP） databases were chosen to retrieve literatures on self- management experience of patients with inflammatory bowel disease from inception to March 31st,2017. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. Integrating method was applied to integrate the results. Results Totally 35 findings were extracted from 6 qualified studies, 7 new categories were generated and finally 3 synthesized results were obtained：l Medical management：in order to maintain remission,diversified methods were used by IBD patients,such as adjusting behaviors and accumulating disease knowledge;2 Emotion management：positive attitude towards life was achieved via dealing with stress and negative emotions caused by IBD;3 Role management：cognitive and behavioral adjustment were taken to adapt the role of IBD patients and maintain the daily role before having IBD. Conclusion Many aspects were involved in self-management of IBD,and emotional management was often overlooked. Guidance and supports should be given by nurses targeting weak links of self-management,in order to improve disease management as well as quality of life for IBD patients.