脑死亡患者家属器官捐献决策体验的Meta整合

The decision-making experience of the families of patients with brain death:a meta synthesis of qualitative studies

目的对脑死亡患者家属器官捐献决策的体验进行Meta整合。方法检索PubMed、Cochrane Library、Web of Science、Embase、CINAHL、ProQuest、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关于脑死亡患者家属器官捐献决策体验的质性研究,检索时限为建库至2022年6月。采用2016版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进行质量评价,对结果进行Meta整合。结果共纳入12项研究,提炼出63个研究结果,归纳出10个新类别,3个整合结果。整合结果1为尊重患者及益处获得;整合结果2为矛盾且复杂的决策过程;整合结果3为渴望正向互动与社会支持。结论脑死亡患者家属器官捐献决策体验复杂,与医护人员的互动质量影响最终的决策结果,医护人员应提供脑死亡相关知识并确保家属正确理解,不断提高器官捐献沟通的专业性,给家属相应的支持及人文关怀,帮助其渡过丧亲之痛,解决决策困境,作出符合其家庭情况的捐献决定。

Objective The aim of this study was to perform a meta-synthesis of the decision-making experience of the families of patients with brain death.Methods Chinese and English databases,including PubMed,Web of Science,Embase,CINAHL,ProQuest,CNKI,Wanfang Database,VIP,and CBM,were searched,and the literature of the qualitative research on organ donation decision-making experience of family members of patients with brain death was retrieved.The time limit of the retrieval was from the establishment to June 2022.The literature quality was evaluated using the 2016 Australian JBI Evidence-Based Health Care Center Quality Evaluation Criteria for Qualitative Research,and the results were consolidated by meta integration method.Results A total of 12 studies were included,and 63 results were extracted and summarized into 10 new categories,which were combined into 3 integrated results.Finally,it is integrated into 3 integrated results,including respect for the patients and the gained benefits,the complex and contradictory decision-making process,and the quality of interaction with medical workers affecting the decision-making results.Conclusion The organ donation decision experience of families of brain death patients is complex,and the interaction quality influences the final decision results.Medical staff should provide brain death knowledge and ensure the correct understanding,constantly improve their professional organ donation communication,give family corresponding support and humanistic care,so as to help them go through the bereavement,solve the decision-making dilemma,conform to the donation decision,make it return to normal healthy life as soon as possible..