肝硬化患者患病体验的Meta整合

Experience of patients with liver cirrhosis:a Meta-integration

目的:系统评价和整合肝硬化患者患病体验的质性研究,为制定有针对性的照护方案以及开展延续护理提供依据。方法:检索PubMed、Embase、CINAHL、PsycINFO、万方、中国知网、维普、中国生物医学文献数据库中关于肝硬化患者患病体验的质性研究,检索时限为建库至2022年3月。对文献进行质量评价和资料提取,采用Meta整合方法对结果进行整合。结果:共纳入10篇文献,提炼出46个明确的研究结果,归纳出9个新类别,得出4个整合结果:肝硬化患者经历躯体、心理和社会功能多个维度的衰弱;肝硬化患者疾病管理能力不足,渴望得到亲朋、医护人员的支持;肝硬化患者存在一定程度的病耻感;肝硬化患者的应对方式迥然不同。结论:医护人员应根据肝硬化疾病轨迹,及时评估患者多维度的衰弱状态,联合家属,给予患者持续、动态的支持和干预,引导患者积极应对疾病,降低患者病耻感。

Objective:To systematically evaluate and integrate qualitative studies on the disease experience of patients with liver cirrhosis,so as to provide evidence for targeted care programme and continuous care.Methods:We searched databases including PubMed,Embase,CINAHL,PsycINFO,Wanfang Data,CNKI,VIP,CBM,from inception to March 2022,to collect qualitative studies exploring the experience of patients with liver cirrhosis.After evaluating the quality of studies and information extraction,the integrating methods was applied to integrate the results.Results:A total of 10 studies were included,46 findings were grouped and 9 categories were summarized.Four integration results were synthesized:frailty in physical,psychological and social functions;insufficient ability of disease management and expected to be supported by relatives,friends and health professionals;stigma;the coping style of patients with liver cirrhosis was very different.Conclusion:Based on trajectory of liver cirrhosis,health professionals should assess the multi-dimensional frailty of the patients timely and provide patients with continuous,dynamic support and intervention,cooperate with family members,so as to guide patients to actively cope with the disease and reduce their stigma.