前列腺癌患者疾病体验质性研究的Meta整合

Meta integration of qualitative research on disease experience in patients with prostate cancer

目的 系统评价前列腺癌患者疾病体验的质性研究,为提高该人群心理健康和建立支持体系提供参考。方法 检索Pub Med、Web of Science、Embase、Cochrane Library、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中收录的关于前列腺癌患者患病体验的质性研究,检索时限从建库至2021年4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对文献质量进行评价,采用汇集性整合方法对结果进行整合。结果 共纳入13篇研究,提炼出50个明确的研究结果,将相似的研究结果归纳形成8个新类别,综合出3个整合结果:症状困扰下的前列腺癌患者自我认知改变伴有倒退感,导致男性自尊受损和夫妻亲密关系疏离;不同情感体验患者在应对策略上存在差异,分别表现为逃避、屈服和创伤后成长;患者存在医患沟通不畅、缺乏同伴支持、社会关注度低等多维度未满足需求,努力寻求相关支持。结论 前列腺癌患者存在多方面疾病体验,护理人员往往忽视患者感受和体验,护理人员在今后工作中需多角度关注并评估患者心理感受,结合积极心理学角度提供综合性身心护理,完善其社会支持,提高其生活质量。

Objective To systematically review the qualitative research on the disease experience of patients with prostate cancer,and to provide references for improving the mental health of this population and establishing a support system. Methods The databases of PubMed,Web of Science,Cochrane,Embase,Cochrane Library,CNKI,VIP,Wanfang,CBM were retrieved on qualitative research about the disease experience of prostate cancer patients.The retrieval period is from the establishment of the database to April 2021. The quality of the literature was evaluated by JBI Critical Appraisal Tool for qualitative studies. Results A total of 13 studies were included,and50 clear study results were extracted. Similar study results were summarized into 8 new categories,and 3 integrated results were synthesized:self-perception changes in symptomatic prostate cancer patients accompanied by regression,leading to impaired male self-esteem and alienation in the intimate relationship of couples;differences in coping strategies among patients with different emotional experiences,which are manifested as avoidance of surrender and post-traumatic growth;patients have unmet needs in multiple dimensions,such as poor doctor-patient communication,lack of peer support,and low social attention,and they strive to seek relevant support. Conclusion Prostate cancer patients have many aspects of disease experience in the whole disease process. Healthcare professionals tend to ignore patients’ feelings and experiences,and should pay attention to and evaluate patients’ psychological feelings from multiple perspectives in the future. They should also provide comprehensive physical and mental care from the perspective of positive psychology to improve social support and improve their quality of life.