癌症患者家属对真实病情告知态度质性研究的Meta整合

Attitudes towards breaking bad news among family members of cancer patients:a Meta-synthesis of qualitative studies

目的了解癌症患者家属对真实病情告知的态度,为临床进行真实病情信息告知提供参考。方法检索PubMed、Embase、Web of Science、CINAHL及中国知网、万方数据、维普网7个中英文数据库,搜集有关癌症患者家属对真实病情告知态度的质性研究,检索时限均为建库至2020年12月28日。采用JBI的汇集性整合方法对结果进行整合。结果共纳入12篇文献,提炼出49个结果,归纳出13个新类别,得到3个整合结果,分别为真实病情完全告知、真实病情部分告知、避免真实病情告知。结论家属对于真实病情告知的态度存在差异。临床医护人员可在积极提高自我沟通能力的基础上,动态、持续地评估患者及家属对真实病情告知的态度及意愿,提供充分的信息支持与社会支持,既促进患者知情权与决定权的实现,又能满足患者需求,降低家属心理负担。

Objective To conduct a systematic review on the attitudes towards breaking bad news among family members of cancer patients,and to provide a reference for clinical staffers′truth telling practice.Methods The databases of PubMed,Embase,Web of science,CINAHL,CNKI,WanFang,and VIP,were searched to collect all the qualitative studies on attitudes and perspectives towards breaking bad news in family members of cancer patients from inception to December 28th,2020.JBI′s Meta-synthesis method was used to integrate the results.Results Totally,49 findings,extracted from 12 qualified studies,were grouped into 13 categories,which finally converged to form 3 synthesized results:disclosure of all the bad news;delivery of bad news selectively;avoidance of delivering bad news.Conclusion The family members of cancer patients held various attitude towards breaking bad news.Medical personnel are suggested to improve their own communication ability,and dynamically and continuously assess the attitude and willingness of patients and family about disclosing bad news.Besides,medical personnel should provide adequate information and social support,which not only helps patients exercise their right to be informed and to make autonomous decisions,but also satisfies patients′needs,and lifts the burden of family members.