恶性肿瘤患者对善终认知的Meta整合

Perceptions of good death among malignant tumor patients:a qualitative meta-synthesis

目的系统整合恶性肿瘤患者对善终认知的质性研究,为开展高质量的肿瘤临终护理,提高恶性肿瘤患者死亡质量提供依据。方法计算机检索相关文献数据库,检索有关恶性肿瘤患者对善终认知的质性研究。使用2016版JBI循证卫生保健中心质性研究质量评价标准对文献进行方法学质量评价,采用汇集性Meta整合法对结果进行整合。结果共纳入16篇文献,提炼出62个研究结果,归纳成11个新的类别,综合成4个整合结果:了解恶性肿瘤诊断及治疗信息并参与临终治疗决策;保持积极心态并为死亡做准备,实现舒适、体面的死亡;不成为家人的负担,并完成对家人的嘱托;得到家庭、宗教、医护团队和社会的支持。结论临终关怀医护人员应尊重恶性肿瘤患者的知情权并帮助患者参与临终治疗决策,通过高质量的临终护理和多学科协作的临终关怀模式满足患者身、心、社、灵的需求,帮助患者实现善终。

Objective To conduct a meta-synthesis of the perceptions of good death in malignant tumor patients and provide theoretical basis for developing high quality hospice care and improving the quality of death in such patients.Methods Relevant electronic databases were searched for qualitative studies on perceptions of good death among malignant tumor patients.The methodological quality of the studies was evaluated using the JBI Critical Appraisal Tool for qualitative studies,and the results were integrated using meta-aggregative approach.Results A total of 16 studies were included and 62 findings were extracted,which were summarized into 11 new categories.Finally,4 integrated results were synthesized:understanding the information on cancer diagnosis and treatment,and participation in end-of-life treatment decisions;maintaining a positive attitude and preparing for a comfortable and dignified death;not to be a burden to the family,and saying goodbye to their family members;getting family,religious,medical and social support.Conclusion Hospice staff should respect patients′right to know and help patients participate in end-of-life treatment decisions.High-quality multidisciplinary hospice care should be provided to meet patients′physical,mental,social and spiritual needs,so as to help them achieve a good death.