胃/空肠造瘘术后肠内营养患者及照顾者真实体验质性研究的Meta整合

The real experience of patients with enteral nutrition after gastro/jejunostomy and their caregivers:a qualitative research Meta-synthesis

目的系统评价胃/空肠造瘘术后肠内营养患者及照顾者真实体验的质性研究,深入了解患者及照顾者的真实感受与身心体验。方法通过计算机检索PubMed、Embase、CINAHL、The Cochrane Library、Web of Science、PsycINFO、中国知网、万方、维普(VIP)和中国生物医学文献数据库(CBM)关于胃/空肠造瘘术后肠内营养患者及照顾者真实体验的质性研究,检索时间均从建库至2019年9月30日。制定纳入排除标准,确定纳入文献,根据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,采用汇集性整合方法对结果进行整合。结果共纳入11项研究,提炼出37个研究结果,基于生命质量理论提取主题为:胃/空肠造瘘术后肠内营养患者及照顾者在健康与功能、心理/精神、社会经济及家庭4个领域经历了改变与挑战、应对与适应、需求与支持的动态循环。结论胃/空肠造瘘术后肠内营养对患者及照顾者生命质量的4个领域均产生不同程度影响,尤其在心理/精神及社会经济领域中患者及照顾者表现出强烈的信息与心理需求,建议医护人员在治疗与护理过程中提供信息与情感支持。

Objective:To systematically evaluate the qualitative study of the real experience of patients with enteral nutrition after gastro/jejunostomy and their caregivers and to deeply understand the real feelings and physical and mental experience of patients and caregivers.Methods:Databases were searched including PubMed, Embase, CINAHL, The Cochrane Library, Web of Science, PsycINFO, CNKI, Wanfang Database, VIP Database and CBM from inception to September 30th, 2019. To collect the qualitative studies on the real experience of patients with enteral nutrition after gastro/jejunostomy and their caregivers. According to the inclusion and exclusion criteria, the included literature was determined, the literature was evaluated according to the quality evaluation criteria of qualitative research of the JBI Evidence-based Health Care Center, and the results were integrated using a collective integration method.Results:A total of 11 studies were included and 37 results were extracted. Based on the quality of life theory, the topics extracted are as follows: patients with enteral nutrition after gastro/jejunostomy and their caregivers experienced dynamic cycle of change and challenge, coping and adaptation, demand and support in the domain of health and function, psychology/spiritual, socioeconomic and family.Conclusions:The four domains of quality of life of patients and caregivers were affected during enteral nutrition after gastro/jejunostomy. In particular, patients and caregivers showed strong inner and information needs in the psychological/spiritual and socioeconomic domain. It is suggested that medical staff should provide effective psychological, emotional and information support in disease treatment and nursing, in order to improve the quality of life of patients and caregivers.