乳腺癌患者夫妻二元应对癌症体验质性研究的系统评价和Meta整合

A systematic review and Meta-analysis of qualitative research on dyadic coping cancer experience in breast cancer patients and their spouse

目的 系统评价有关乳腺癌患者与配偶夫妻二元应对癌症的经历和体验,为制订夫妻共同应对乳腺癌的干预措施提供循证依据.方法 计算机检索the Cochrane Library、PubMed、Web of Science、CINAHL、Embase、PsycINFO、SCOPUS、CBM、CNKI、VIP和万方数据库中从建库至2019年3月相关的质性研究并进行筛选,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"进行质量评价,采用Meta整合方法对最终纳入研究的结果进行整合.结果共纳入18项研究,提炼出59个研究结果,归纳形成11个类别,并综合形成3个整合结果,分别为夫妻利用内在凝聚力应对乳腺癌、夫妻寻求利用外部支持来应对乳腺癌、夫妻在应对乳腺癌时仍面临着挑战和困难.结论乳腺癌的确诊是一个重大家庭事件,患者和配偶往往作为一个整体去应对这一突发事件,医护工作者应该重视配偶在这一过程中的重要作用,以夫妻为中心进行相应的干预和指导,使其能更好地应对癌症.

Objective Tosystematically review the dyadic coping cancer experience in breast cancer patients and their spouses so as to provide an evidence-based reference for making intervention for couple to cope with breast cancer. Methods Qualitative researches were retrieved in the Cochrane Library, PubMed, Web of Science, CINAHL,Embase, PsycINFO,SCOPUS,CBM, Chinese National Knowledge Infrastructure (CNKI),VIP and WanFang data from building database to March 2019. Those researches were also screened. The quality evaluation was carried out with the "Australia Joanna Briggs Institute (JBI) Critical Appraisal Tool for qualitative studies". Meta-analysis was used to integrate the results of included researches. Results A total of 18 researches were included and 59 results were extracted. Those results were induced into 11 classifications and were synthesized into 3 integrated results including that couple coped with breast cancer by internal cohesion,external support and couple faced challenges and difficulties when coping with breast cancer. Conclusions Diagnosisof breast cancer is a major family event. Patients and their spouses cope with this emergency as a whole. Medical workers should pay attention to the influence of spouses in the process and carry out intervention as well as guide centered on couple to make the cope with cancer well.