乳腺癌术后患者淋巴水肿真实体验质性研究的系统评价

Qualitative Studies on the Psychological Experience of Post-operative Patients with Breast Cancer-related Lymphedema:A Systematic Review

目的系统评价及整合乳腺癌术后患者淋巴水肿真实体验的质性研究的结果,为乳腺癌患者术后预防淋巴水肿提供参考依据。方法计算机检索PubMed、Cochrane图书馆、Web of Science、Science Direct、Embase、中国期刊全文数据库(Chinese National Knowledge Infrastructure,CNKI)、万方数据库、维普期刊资源整合服务平台、中国生物医学数库(Chinese Biomedical Literature Database,CBM)等国内外数据库,建库以来至2018年3月相关的质性研究文献。参照澳大利亚JBI循证卫生保健中心质性研究质量评价标准,采用Meta整合的方法对研究结果进行整合。结果共纳入9篇文献,提炼出35个研究结果,形成10个新的类属,得到3个整合的结果:淋巴水肿带来的改变;信息的缺乏;生活的希望。结论淋巴水肿严重影响了乳腺癌术后患者的生理、心理及社会功能,患者控制不良情绪、自我管理疾病的意识有待增强,社会支持系统亟需完善,医护人员应及时有效地给患者赋能,促进患者的身心健康。

Objective To systematically review and synthesize the psychological experience of post-operative patients with breast cancer-related lymphedema,in order to provide a reference to prevent lymphedema.Methods PubMed,the Cochrane Library,Web of Science,Science Direct,Embase,Chinese national knowledge infrastructure,Wanfang database,VIP and Chinese biomedical literature database were included to retrieve literature on the patients with breast cancer-related lymphedema from inception to March 2018.The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies.The Integrating Methods was applied to synthesize and integrate the results.Results A total of 35 findings were extracted from 9 qualified studies.10 new categories were integrated.Finally,3 synthesized results were summarized,including the changes caused by lymphedema,the lack of information and the hope of life.Conclusions Lymphedema seriously affects patients’physiological,psychological and social functions after breast cancer surgery.Patients’ability of mood-control and self-management needs to be enhanced,the social support system needs to be improved,and the medical staffs should empower the patients,thus promote the patients’physical and mental health.