脊髓损伤患者创伤后成长体验质性研究的Meta整合

Meta-synthesis of qualitative studies on posttraumatic growth experience among patients with spinal cord injury

目的对脊髓损伤患者创伤后成长体验的质性研究进行系统评价和Meta整合。方法计算机检索PubMed、Cochrane图书馆、Web of Science、中国知网(CNKI)、万方数据库、维普网、中国生物医学文献服务系统(SinoMed)等国内外数据库中关于脊髓损伤患者创伤后成长真实心理体验的质性研究文献。检索时限均为建库至2018年12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(2016)对文献进行评价,并采用汇集性整合方法对结果进行整合与分析。结果综合分析后形成3个整合结果:脊髓损伤患者创伤后成长历程曲折,需要经历绝望中的挣扎、对自我存在意义的反思获得成长;个人资源、认知加工、参加有意义的活动和社会支持都是脊髓损伤患者创伤后成长的保护性因素;脊髓损伤患者在认知行为层面的应对策略。结论医护人员、家属及社会应相互协作,挖掘患者个人有利资源,采取干预措施,提高患者创伤后成长水平,使其积极面对疾病及生活,力争早日重返社会。

Objective To systematic review and meta-synthesize qualitative studies on posttraumatic growth experience among patients with spinal cord injury.Methods PubMed,Cochrane library,Web of Science,CNKI,Wanfang database,VIP and SinoMed were included to retrieve qualitative studies published from inception to December 2018 regarding posttraumatic growth experience among patients with spinal cord injury.The JBI Critical Appraisal Tool for qualitative studies was used to evaluate the quality of the included studies.The searching results were synthesized by employing integrating methods.Results Three integration results were obtained after comprehensive analysis:patients with spinal cord injury took a grinding journey to gain posttraumatic growth through struggle in despair and reflection on the meaning of self-existence;personal resources,cognitive processing,participation in meaningful activities and social support were protective factors for posttraumatic growth in patients with spinal cord injury;patients with spinal cord injury developed various cognitive and behavioral strategies to deal with traumatic events.Conclusion Medical staff,family members and society should cooperate with each other to explore the patient′s personal resources and take intervention measures to improve the level of patients′posttraumatic growth,so that they can actively face the disease and life and strive to return to society as soon as possible.