家庭管饲患者带管生活真实体验的Meta整合

The real experience of living with a tube in adult patients with home enteral tube feeding:a Meta-synthesis of qualitative studies

目的:系统评价家庭管饲患者带管生活真实体验的质性研究,为构建居家护理服务体系提供依据。方法:计算机检索Web of Science、Cochrane Library、PubMed、PsycINFO、Embase、中国知网、中国生物医学文献数据库、维普与万方数据库中公开发表相关的质性研究,检索时间为建库至2020年3月31日。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对文献进行评价,并采用汇集性整合方法对研究结果进行整合。结果:共纳入17篇文献,提炼出73个结果,归纳为9个新类别,综合成4个整合结果。整合结果1:家庭管饲决策经历(个体化的决策经历、决策的支持性需求)。整合结果2:失去正常生活(躯体负性经历、心理负性体验、社会生活负性经历)。整合结果3:调整应对新常态(个体自我应对、积极心理调节)。整合结果4:家庭管饲挑战和价值(家庭管饲过渡、家庭管饲的价值)。结论:家庭管饲患者阶段性的体验揭示了管饲过程的积极感受和困难,医护人员应关注患者的支持性需求,提供动态、多方面、延续性的医疗服务。

Objective:To systematically review the real experience of living with a tube in patients with home enteral tube feeding and provide evidence-based guidance for the home care service system.Methods:We searched databases including Web of Science,Cochrane Library,PubMed,PsycINFO,Embase,CNKI,CBM,VIP,Wanfang Data from inception to March 2020.The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies.The Integrating Methods was applied to integrate the results.Results:A total of 75 findings were extracted from 17 qualified studies and then 4 synthesized results were summarized from 9 new categories.Integration result 1:decision making for home tube feeding(individualized decision and supporting needs for decision).Integration result 2:the loss of normal life(negative body experience,negative psychological experience,and negative experience of social life).Integration result 3:adjusting to the new normal(self coping and positive psychological adjustment).Integration result 4:the challenges and values of family tube feeding(transitioning back to oral and value of home enteral tube feeding).Conclusion:The staged experience reveals the positive feelings and difficulties of the tube feeding process.Healthcare workers should pay more attention to patients'needs,and provide dynamic,multi-aspect,and transitional medical care service.