居家安宁疗护照顾者照护体验质性研究的Meta整合

Qualitative studies on experience of home hospice caregivers:a meta-synthesis

目的系统评价针对居家安宁疗护照顾者照护体验的质性研究,以期为改善居家安宁疗护照顾者照护质量,构建居家安宁疗护支持体系提供借鉴。方法计算机系统检索Cochrane Library、澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、Embase、PubMed、PsycINFO、Web of Science、CINAHL、中国知网、万方数据库、维普数据库、中国生物医学文献数据库,检索有关居家安宁疗护照顾者照护体验质性研究的文献,检索时限为建库至2021年6月。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对文献进行评价,采用Meta整合方法对纳入文献的研究结果进行整合分析。结果共纳入19篇文献,提炼出80个主要的研究结果,归纳成7个新的类别,综合成3个整合结果:①照顾者负性体验强烈;②照顾者积极应对负性体验,收获个人成长;③照顾者寻求多方面支持。结论居家安宁疗护照顾者照护负担重,身心压力较大,渴望多方支持,建议重视居家安宁疗护照顾者的内心体验和需求,构建居家安宁疗护区域同质化联动支持体系,从而改善居家安宁疗护质量。

Objective To systematically evaluate the qualitative research on the care experience of home hospice caregivers,in order to provide references for paying attention to the care quality of home caregivers and building a home hospice care support system.Methods Qualitative studies on the nursing experience of home hospice caregivers were searched in electronic databases,including the Cochrane Library,JBI,Embase,PubMed,PsycINFO,Web of Science,CINAHL,CNKI,WanFang,CBM Database.The search time was from inception to June 31,2021.Quality of the literature were evaluated according to JBI Critical Appraisal Checklist for Qualitative Research and then the meta-synthesis was performed.Results Totally 19 studies were included and 80 research results were extracted.Finally 7 categories and 3 integrated results were formed.Integrated result:①Caregivers have strong negative experience;②Caregivers actively respond to negative experiences and gain personal growth;③Caregivers seek multifaceted support.Conclusion Home hospice caregivers have heavy care burden and great physical and mental pressure,and are eager for multi-party support.It is suggested to pay attention to the inner experience and needs of family caregivers,and build a regional homogeneous linkage support system of home hospice,so as to improve the nursing quality of home hospice.