乳腺癌病人患病体验质性研究的Meta整合

Meta aggregative synthesis of qualitative researches on experience of breast cancer patients

[目的]整合相关质性研究,系统评价乳腺癌病人患病过程中的体验。[方法]检索PubMed、EMbase、Science Direct、Web of Science、EBSCO以及中国生物医学数据库(CBM)、万方(WanFang)、中国知网(CNKI)、维普数据库(VIP)等数据库从建库至2018年1月15日相关的质性研究,采用汇集性整合(Integrative/Aggregative synthesis)的方法进行结果整合。[结果]共纳入7项研究,提炼34个完整的研究结果,归纳出14个新的类别,得到3个整合结果。①身心感受:病人在疾病诊断、治疗、护理、康复过程中能够感知疾病带给自己的身心变化;②需求:病人不断进行认知、行为调整的过程中产生了多方面、多形式的支持需求和需要;③信仰和灵性感知:病人通过对疾病的自我认识和外界感知,她们选择信仰上帝或者更加崇拜上帝,觉得患病是上帝对自己的安排。[结论]乳腺癌病人患病体验涉及方面众多,以往医护人员着重于疾病的治疗和康复,忽视了病人的身心变化、感受和体会。医护人员应针对病人患病过程中的薄弱环节,给予指导和支持,帮助其更好地管理疾病。

Objective: To systematically evaluate the experience of patients with breast cancer by integrating relevant qualitative studies. Methods: Qualitative studies were retrieved in PubMed,EMbase,Science Direct,Web of Science,EBSCO,CBM,WanFang,CNKI and VIP from the database building until January 15,2018.The integrative/aggregative synthesis method was adopted to integrate results. Results: A total of 7 studies were included,34 complete research results were extracted,14 new categories were concluded,and 3 integrated results were obtained.①Physical and mental feelings:in the process of disease diagnosis,treatment,nursing and rehabilitation,patients could perceive the physical and mental changes;②Needs:in the process of continuous cognitive and behavioral adjustment,patients had developed various and multi-form supports and needs.③Faith and spiritual perception:through self-knowledge and external perception of the disease,patients chose to believe in god or worship god more,thinking that illness was god′s arrangement for them. Conclusion: The experience of breast cancer patients involved many aspects.In the past,the medical staff focused on the treatment and rehabilitation of the disease,ignoring the patients′ physical and mental changes,feelings and experience.Medical staff should give guidance and support to the weak links in patients′ disease process to help them better manage the disease.