乳腺癌患者乳房重建心理体验质性研究的Meta整合

Women’s experience of undergoing reconstructive surgery after breast cancer:a qualitative Meta-synthesis

目的系统总结乳腺癌患者乳房重建的心理体验,全面了解其内心需求,为更好地开展临床医疗工作提供依据。方法计算机检索Cochrane Library、JBI循证卫生保健国际合作中心图书馆、PubMed、EMbase、Scopus、Web of Science、护理及相关健康领域文献积累索引数据库、美国心理学数据库、中国知网、中国生物医学文献数据库,搜集有关乳腺癌患者乳房重建心理体验的质性研究,检索年限为建库至2018年11月。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法进行结果整合。结果共纳入10篇研究,提炼出29个完好明确的研究结果,将相似的研究结果归纳形成7个新类别,得出3个整合结果。乳房重建的决策经历:信息不足与彷徨;乳房重建后的痛苦经历:手术过程的艰难和对重建结果的沮丧;乳房重建后的调适:心理和生活方式的调适。结论医护人员应关注乳房重建患者的心理变化和信息需要,提供必要的支持和帮助,促进患者适应乳房重建后的生活,提高乳腺癌患者的生活质量。

Objective To systematically review women’s experience of undergoing reconstructive surgery after breast cancer to fully understand patients’ psychological needs and provide better evidence for clinical work.Methods We searched databases including the Cochrane Library,Joanna Briggs Institute Library,PubMed,EMbase,Scopus,Web of Science,CINAHL,PsycINFO,CNKI,and CMB from inception to September 2018,to collect qualitative studies on women’s experience of undergoing reconstructive surgery after breast cancer. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods.Results A total of ten studies were included. Twenty-nine complete findings were grouped according to similarities to form seven new categories. These categories resulted in three synthesized findings:decision making for breast reconstruction:lack of information and hesitation;painful struggle after breast reconstruction:difficulties insurgical process and frustration with the outcome;adjustment after breast reconstruction:psychological and life style adjustment.Conclusion Healthcare workers should pay attention to psychological changes and information needs of patients with breast reconstruction,provide necessary support to help patients to adapt to life after breast reconstruction,and improve patients’ quality of life.