脑卒中患者非正式照顾者在社区医疗保健服务中的体验质性研究的系统评价

Systematic evaluation of the qualitative study on the experience of informal caregivers of stroke patients in com -munity health care services

目的 整合相关质性研究并系统评价脑卒中患者非正式照顾者在社区卫生医疗保健服务中的体验,为社区医疗保健服务如何减轻照顾者负性体验提供潜在解决方案.方法 检索PubMed、EMbase、Web of Science、PsycINFO、CINAHL中国知网和万方数据库,搜集关于脑卒中患者非正式照顾者在社区卫生医疗保健服务方面体验的质性研究,检索时限从建库至2018-06.以"澳大利亚JBI循证卫生保健中心质性研究质量评价(2016)"为基准,运用汇集性整合方法对结果进行整合.结果 共纳入15篇文献,提炼36个结果,归成11个新类别,合成2个整合结果,整合结果1:脑卒中患者照顾者依赖社区医疗保健服务帮助解决居家照顾难题;整合结果2:照顾者感知被服务边缘化,社区医疗保健服务亟需完善.结论 脑卒中患者非正式照顾者在社区卫生医疗保健系统中的体验应引起相关部门的高度重视,在照顾者居家照护期间,社区保健服务应注意满足其对访问服务途径及喘息服务,信息 、培训及心理支持,延续护理等方面的需求,从而减轻照顾者负性体验,提高患者和照顾者的生活质量.

Objective To integrate relevant qualitative studies and systematically evaluate the experience of informal caregivers of stroke patients in community health care services,so as to provide potential solutions for how to alleviate the negative experience of caregivers in community health care services.Methods Search PubMed,EMbase,Web of Science,PsycINFO,CINAHL China CNKI and WanFang database to collect qualitative research on the experience of informal caregivers of stroke patients in community health care services.The retrieval time is from the establishment of the database to June 2018.Based on"Quality Assessment of Qualitative Research(2016)of JBI Evidence based Health Care Center in Australia",the results were integrated by using aggregate integration method.Results A total of 15 articles were included,36 results were extracted and classified into 11 new categories and 2 integration results were synthesized,integration results 1:Caregivers of stroke patients relied on community health care services to help solve the problem of home care;integration results 2:Caregivers perceived that they were marginalized and community health care services needed to be improved urgently.Conclusion The experience of informal caregivers of stroke patients in community health care system should be highly valued by relevant departments.During the period of caregivers'care for patients,community health care services should pay attention to meeting their needs for access to services and breathing services,information,training and psychological support,and continuing care,so as to alleviate caregivers'negative experience and improve patients'quality of care and the quality of life of caregivers.