头颈癌患者身体意象体验质性研究的系统评价

A meta-synthesis of body image experience in patients with head and neck cancer

目的系统评价头颈癌患者身体意象的体验与感受,为医护人员开展干预工作提供理论依据。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、PsycINFO、CINAHL、中国知网、万方、维普及中国生物医学文献数据库,检索关于头颈癌患者身体意象体验的质性研究,检索时限为建库至2020年12月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法对结果进行整合。结果共纳入9篇文献,提炼出44个研究结果,对相似的研究结果进行归纳形成7个新类别,综合成3个整合结果:头颈癌引起的身体意象改变给患者带来严重的影响、头颈癌患者身体意象问题的影响因素、头颈癌患者采取应对身体意象问题的方式。结论头颈癌患者身体意象问题严峻,需要引起医护人员对其身体意象问题的重视;发挥家庭支持的积极作用,同时兼顾头颈癌患者的自主权,实现头颈癌患者自主权与家庭支持的平衡;传扬正确的社会文化,推进社会对头颈癌患者身体意象问题的关注。

Objective To systematically review body image experience of patients with head and neck cancer(HNC)and to provide healthcare professionals with foundations to develop interventions.Methods Qualitative studies on body image experience of HNC patients,published by December 2020,were searched in English and Chinese databases,including PubMed,Web of Science,Embase,Cochrane Library,PsyINFO,CINAHL,CNKI,Wanfang,VIP and CBM.The quality of included studies were evaluated by Joanna Briggs Institute Critical Appraisal Tool for qualitative studies.Results A total of 9 eligible studies were included.Based on the similarities of the extracted 44 findings,we concluded 7 new categories and further synthesized 3 integrated themes,including serious impact of body image change on HNC patients,various influencing factors of body image experience in HNC patients,and different coping strategies of body image issues in HNC patients.Conclusion Body image is a critical issue in HNC patients.To deal with this issue,more awareness and interventions should be given from healthcare professionals.Family supports are encouraged,with a balance with patients’autonomy.More appropriate social and cultural attention to the body image issues in HNC patients are needed.