透析病人等待肾移植期间体验的Meta整合

Qualitative research on experience of hemodialysis patients during waiting for renal transplantation:a Meta synthesis

[目的]系统评价透析病人等待肾移植期间的体验。[方法]检索建库至2019年7月13日PubMed、the Cochrane Library、Web of Science、Science Direct、EMbase及中国知网(CNKI)、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM)、维普数据库(VIP)中与主题相关的质性研究,由2名研究者独立完成文献筛选、数据提取后,采用2017版澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,采用Meta整合方法进行结果整合。[结果]共纳入9项研究、34个结果,将其整合为3个结果、8个新类别:心理体验,即随着等待时间推移,病人心理体验呈动态变化,经历了从期待到失望3个阶段;不确定感,即病人受主观因素及客观因素影响,等待肾移植期间生活在不确定中;需求,即“等候者”的新角色给病人带来了多重改变,病人在不断自我调适以适应新角色的过程中产生了不同层次的需求。[结论]医务人员应关注透析病人等待肾移植期间心理体验的阶段性变化及不同层次需求,提供针对性的指导和支持,帮助病人顺利度过等待期。

Objective:To systematically evaluate experience of hemodialysis patients during waiting for kidney transplantation.Methods:Qualitative studies related to discussion theme were retrieved from following databases,such as PubMed,the Cochrane Library,Web of Science,Science Direct,EMbase,CNKI,Wanfang Data,CBM,VIP were systematically searched.The retrieval time was from inception to July 31,2019.Literatures screening and data extraction were carried out by two researchers,independently.2017 version of Australian JBI Evidence⁃based Health Care Center Qualitative Research Quality Evaluation Standard was used to evaluate quality of literatures.Meta synthesis was used to analyze results.Results:A total of 9 studies were included,involving 34 results.They were synthetized into 3 outcomes,8 new categories.Psychological experience:as time went by,patients'psychological experience changed dynamically.They had undergone 3 periods from expectation to disappointment.Uncertainty:patients was affected by subjective factors.and objective factors.Their lifes were surrounded by uncertainty during period of waiting for kidney transplant.Demand:the new roles of"waiter"bringed multiple changes to patients.They had different levels of needs in the process of self adjustment to adapt to new roles.Conclusions:Medical staff should pay attention to stayed psychological experience changes and different levels of needs of hemodialysis patients during waiting for renal.In addition,they also should provide targeted guidance and support to help patients pass the waiting period smoothly.