脑卒中后尿失禁患者疾病体验质性研究的系统评价

The illness experience of patients with post-stroke urinary incontinence:a qualitative meta-synthesis

目的系统评价脑卒中后尿失禁(post-stroke urinary incontinence,PSUI)患者的疾病体验,为医护人员开展精准化干预提供参考。方法计算机检索Cochrane Library、PubMed、EMbase、CINAHL、Web of Science、PsyINFO、CBM、中国知网及万方数据库关于PSUI患者疾病体验的质性研究,检索时限为建库至2019年5月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准对文献质量进行评价,采用汇集性整合方法对结果进行整合。结果共纳入5篇文献,提炼34个研究结果,归纳形成7个新类别,合成2个整合结果:①PSUI患者负性情绪较重、人际关系紧张,并伴有日常生活活动受限;②PSUI患者存在护患沟通不畅、信息获取不足而导致自我应对欠佳,希望得到家庭和社会的支持。结论医护人员应高度重视PSUI患者疾病体验和信息需求,及时给予心理疏导、医疗支持和人文关怀,帮助患者提高应对疾病的信心,改善其生活质量。

Objective To systematically review the illness experience of patients with post-stroke urinary incontinence(PSUI)and provide references for healthcare workers to carry out precision nursing intervention.Methods We searched databases including the Cochrane Library,PubMed,EMbase,CINAHL,Web of Science,PsyINFO,CBM,CNKI and Wanfang from inception to May 2019 to collect qualitative studies on the illness experience of PSUI patients.The quality of included studies was evaluated by JBI Critical Appraisal Tool for qualitative studies.Results A total of 5 studies were included,with 34 complete research findings grouped into 7 categories by their similarities.Two integrated findings were synthesized:patients with PSUI can have severe negative emotion and interpersonal tension with limited daily activities;patients with PSUI have poor self-management due to communication barriers and lack of information,therefore,they are longing for family and social support.Conclusion Healthcare professionals should pay more attention to the illness experience and information needs of patients with PSUI,and provide psychological counseling,medical support and humanistic care,in order to help patients to improve their confidence in coping with the disease and improve theirquality of life.