慢性心力衰竭患者自我管理体验质性研究的Meta整合

Self-management of Patients with Chronic Heart Failure:A Qualitative Meta-integration

目的系统总结慢性心力衰竭患者的自我管理体验,全面了解其自我管理行为,为制定自我管理措施提供依据。方法检索The Cochrane Library、JBI、CINAHL、PubMed、Web of Science、Science Direct、EBSCO、中国生物医学文献数据库、中国知网、万方、维普数据库从建库至2019年11月10日收录的关于慢性心力衰竭患者自我管理体验的质性研究。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评价文献质量,采用Meta整合的方法进行整合。结果共纳入19项研究,提炼出74个研究结果,归纳形成7个新类别,综合得到3个整合结果。整合结果1:发展疾病相关健康行为,包括感知症状、建立健康行为2个类别;整合结果2:寻求与领悟支持,包括希冀外界支持、渴求疾病管理知识2个类别;整合结果3:积极应对,包括积极应对疾病、适应角色变化、领悟生命意义3个类别。结论慢性心力衰竭患者意识到自我管理的重要性,在不断总结经验、调整自身行为的过程中发展疾病管理技能,逐步适应患病后生活,积极地建构新的生命意义。

Objective To systematically review the self-management experience of patients with chronic heart failure(CHF),to comprehensively understand patients’self-management behaviors and provide reference for formulating self-management measures.Methods We searched databases including The Cochrane Library,JBI,CINAHL,PubMed,Web of Science,Science Direct,EBSCO,CBM,CNKI,Wanfang,and VIP to collect qualitative studies on management experience of CHF patients from the inception to 10 November,2019.The quality of the literature was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia.The results were integrated using a collective integration method.Results A total of 19 studies were included;74 research results were extracted;7 new categories were summarized,and 3 integrated results were obtained:symptom perception and development of healthy behavior to maintain a good physiological state;facing the disease and seeking social support through multiple channels;adapting to the role change and gaining comfort of the soul in the process of understanding the meaning of life.Conclusion CHF patients gradually realizes the importance of self-management and develop disease management skill in the process of experience summary and behavior adjustment.More encourage and social support are conducive to helping patients to rebuild their life goals,pursue the meaning of life,and ultimately improve the quality of life.