生命末期患者性与亲密关系评估的最佳证据总结

Best Evidence Summary for Assessment of Sexuality and Intimacy Relationship for Patients with Terminal Stage

目的检索并获取生命末期患者性与亲密关系评估的最佳证据,为医护人员评估生命末期患者性与亲密关系提供参考。方法检索BMJ Best Practice、Cochrane图书馆、OVID循证数据库、循证护理搜索引擎SUM Search和Turning Research Into Practice Database(TRIP Database)、美国指南网(National Guideline Clearing house,NGC)、英国国家临床医学研究所指南库(National Institute for Health and Care Excellence,NICE)、Pubmed、Web of Science、荷兰医学文摘数据库(Excerpta Medical Datebase,EMbase)、PQDT博硕士论文数据库文摘库(ProQuest Dissertations&Theses A&I,PQDT)、医脉通、中国知网、万方数据库、中国生物医学文献数据库(China Biology Medicine disc,CBMdisc)和维普中文科技期刊数据库关于生命末期患者性与亲密关系评估的所有证据。由2名研究员对文献质量进行评价和证据提取。结果共纳入8篇文献,其中2篇质性研究、6篇系统综述。共提取30条证据,综合成5个维度,23条最佳证据,包括评估的重要性、评估内容、评估的障碍因素、评估的注意事项、促进性与亲密关系评估策略。结论医护人员应重视对生命末期患者进行性与亲密关系的评估,明确评估内容,克服评估的障碍因素,加强性与亲密关系方面的培训和教育,并根据中国含蓄内敛的文化,在尊重患者自愿、隐私的前提下,有针对性的选择证据。

Objective To summarize the best evidence of assessing sexual and intimate relationship for patients at the terminal stage of life and to provide reference for health care professionals.Methods We searched BMJ Best Practice,Cochrane Library,OVID,SUM Search,Turning Research Into Practice Database(TRIP Database),National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),PubMed,Web of Science,Embase,Proquest,Medlive,CNKI,Wanfang Database,CBMdisc and VIP Journals of Chinese Science for evidence pertaining to assessment of sexual and intimate relationship for patients at the terminal stage of life.Two researchers independently assessed the quality of the literature and extracted data.Results Eight articles were enrolled,including 2 qualitative studies and 6 systematic reviews.A total of 30 pieces of evidence were extracted and integrated into 5 dimensions with 23 pieces of best evidence,including the importance,content,obstacle factors of evaluation,precautions and the strategies of improving sexuality and intimate relationship.Conclusion Health care professionals should pay attention to the assessment of sexual and intimate relationships in patients at the end of life.It is important to clarify assessment content,overcome the obstacles to the assessment,and provide more training of sexual and intimate relationship assessment.According to the implicit and introverted culture of China,health care professionals should make targeted evidence choice on the premise of respecting patients’willingness and privacy.