产妇经历胎儿畸形终止妊娠真实体验的Meta整合

Women’s Real Experiences of Termination of Pregnancy for Fetal Malformation:A Meta-synthesis

目的系统评价产妇经历胎儿畸形终止妊娠的真实体验。方法计算机检索PubMed、EMBase、Web of Science、The Cochrane Library、CINAHL、中国知网、维普数据库和万方数据库,对有关产妇经历胎儿畸形终止妊娠真实体验的质性研究进行收集。检索时限为从建库至2021年2月。文献质量评价采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准,选取汇集性整合的方法。结果共纳入11项研究,提炼出48个研究结果,归纳为9个新类别,得到3个整合结果。整合结果1为胎儿畸形终止妊娠对产妇造成的影响,包括4个类属:生理痛苦、心理痛苦与绝望感、反刍与自责、矛盾与内疚。整合结果2为创伤后成长,包括2个类属:调动积极认知、实现生活重建。整合结果3为外界支持环境对产妇的影响,包括3个类属:一般社会支持、医疗生殖保健服务、社会文化环境。结论胎儿畸形终止妊娠对产妇身心健康产生巨大影响,家属、医护人员及整个社会应重点关注这一特殊群体的身心体验,注重外界环境给产妇带来的影响作用,在诊疗及康复过程中给予多元化的支持性照护与关爱,协助其进行角色转变,恢复身心健康。

Objective To systematically integrate the real experiences of termination of pregnancy for a fetal malformation.Methods We searched databases including PubMed,EMBase,Web of Science,The Cochrane Library,CINAHL,CNKI,VIP and Wanfang Data to collect qualitative studies about the real experiences of termination of pregnancy for fetal malformation from the inception to February 2021.The quality of studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia and meta-synthesis was used to integrate the results.Results A total of 11 studies were retrieved;48 findings were grouped according to their similarities to form 9 categories and 3 integrated results were obtained:impact of termination of pregnancy for fetal malformation on women,including physical pain,psychological pain and desperation,self-condemned and guilty;posttraumatic growth,including positive cognition to help rebuild life;impact of external support environment,including general social support,reproductive health service,and socio-cultural environment.Conclusion Termination of pregnancy for fetal malformation has a great impact on physical and mental health of women.Family members,medical staff and the whole society should pay attention to the physical and mental experiences of this special group as well as the influence of the external environment on them,and diversified supportive care in the process of diagnosis,treatment and rehabilitation are beneficial to helping them change their roles and keep physical and mental health.