白血病患儿照顾者照顾体验质性研究的Meta整合

Caregivers′experience of children with leukemia:a qualitative Meta-synthesis

目的:整合相关质性研究,系统评价白血病患儿照顾者的照顾体验及心理感受,为临床护理人员开展相关的护理措施提供依据。方法:运用PICoS模型构建循证问题及纳入、排除标准,计算机检索the Cochrane Library、PubMed、MedLine、EMbase、Web of Science、CINAHL数据库及中国生物医学文献数据库、中国知网、万方数据库、维普数据库中关于白血病患儿照顾者照顾体验的质性研究,检索时间均为建库至2021年2月。采用澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心质性研究质量评价标准(2016)对文献进行质量评价,采用Meta整合中的汇集性整合方法进行结果整合。结果:共纳入21项研究,提炼出36个研究结果,归纳形成9个新的类别,得出3个整合结果:白血病患儿照顾者心理体验复杂,心理压力较大,存在心理需求;照顾者家庭生活受到影响,照顾者需要进行角色调整;照顾者社会支持系统薄弱,有疾病相关知识、医疗及护理技术、经济支持、心理调节等方面的需求。结论:现有证据表明,白血病患儿照顾者心理体验复杂,承受着多方面的压力,具有多样化的需求。临床护理人员应了解白血病患儿照顾者的心理体验,给予相应的支持与指导,提升照护能力,促进照顾者的身心健康。

Objective:To integrate relevant qualitative studies and systematically evaluate the experience and psychological feelings of caregivers of children with leukemia,and provide a basis for clinical caregivers to carry out relevant care measures.Methods:PICoS model was used to construct evidence-based problems and inclusion and exclusion criteria,qualitative studies on the caregiving experience of carers of children with leukemia were retrieved from the Cochrane Library,PubMed,MedLine,EMbase,Web of Science,CINAHL,CBM,CNKI,WanFang database and VIP,the retrieval time was from database establishment to February 2021.The quality of the literature was evaluated by the Australian JBI Centre for evidence-based health care quality assessment criteria for qualitative research(2016),and the results were integrated using the pooled integration method in Meta integration.Results:A total of 21 studies were included and 36 findings were distilled,the similar findings were grouped into 9 new categories,resulting in 3 consolidated findings.Caregivers of children with leukemia have complex psychological experiences,high psychological stress and psychological needs;Caregivers′family life was affected and caregivers need to make role adjustments;Caregivers have weak so cial support systems and needs for disease-related knowledge,medical and nursing skills,financial support and psychological adjustment.Conclusion:Current evidences shows that caregivers of children with leukemia have complex psychological experiences,with multiple stresses and diverse needs.Clinical nurses should understand the psychological experiences of caregivers of children with leukemia and provide appropriate support and guidance to enhance caregiving and promote the physical and mental health of caregivers.