慢性心力衰竭患者自我护理体验质性研究的Meta整合

Qualitative study of self-care experience in patients with chronic heart failure:a Meta-synthesis

目的系统评价和整合慢性心力衰竭患者自我护理体验,为构建慢性心力衰竭患者自我护理干预方案提供借鉴。方法计算机检索PubMed、PsycINFO、Web of Science、Embase、CINAHL、Cochrane Library及中国知网、中国生物医学文献数据库、万方医学数据库、维普数据库等中英文数据库,收集关于慢性心力衰竭患者自我护理体验的质性研究,检索时限为建库至2021年1月31日。采用澳大利亚Joanna Briggs Institute循证医疗保健中心定性研究质量评价标准进行文献质量评价,采用汇集性方法对纳入文献进行整合。结果最终纳入13篇文献,提炼出50个研究结果,将相似结果整合后得出7个新类别,综合为2个整合结果。整合结果1:慢性心力衰竭患者实施自我护理过程中受多种因素影响;整合结果2:随着时间的推移,患者开始与疾病共存,通过发掘内心正性心理感受,利用个人信念选择积极应对,实现自我价值。结论慢性心力衰竭患者在疾病自我护理过程中受多种影响因素制约,医护人员应重视患者在自我护理管理过程中的需求,给予针对性的支持与帮助,调动其自我管理的积极性。

Objective To systematically review and integrate the self-care experience of patients with chronic heart failure,so as to provide a reference for the construction of self-care plan for patients with chronic heart failure.Methods Qualitative studies on the self-care experience of patients with chronic heart failure were retrieved by computer in Chinese and English databases such as PubMed,PsycINFO,Web of Science,Embase,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database,WanFang Med Database and VIP,and the retrieval time limit was from the establishment of the database to January 31,2021.The quality of the studies were assessed using the Critical Appraisal Tool for qualitative studies of Joanna Briggs Institute Evidence-Based Health Care Centre in Australian.A pooled method was used to integrate the included articles.Results A total of 13 articles were included.A total of 50 research results were extracted,and 7 new categories were obtained by integrating similar results,which were combined into 2 integrated results.Integrated result 1,that was,multiple factors affected the implementation of self-care in patients with chronic heart failure.Integrated result 2,that was,over time,the patient began to coexist with the disease,and realized self-worth by exploring positive psychological feelings and choosing positive responses using personal beliefs.Conclusions Chronic heart failure patients are constrained by a variety of factors in the process of disease self-care.Medical and nursing staff should pay attention to the needs of patients in the process of self-care management,provide targeted support and help,and arouse their enthusiasm for self-management.