延续性护理服务影响因素质性研究的Meta整合

Meta-integration of the effects of continuing care services on quality

目的系统评价我国护理人员开展延续性护理服务的质性研究,全面整合延续性护理服务的影响因素,为促进我国延续性护理发展提供指导。方法检索PubMed、EMbase、Web of Science、Cochrane Library、CMB、SinoMed、CINAHL、中国知网、万方数据、维普中相关质性研究,检索时限为建库到2022年3月;采用NoteExpress软件筛选和分析文献,使用2017版澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行质量学评价,采取汇集性整合的方法进行Meta整合,通过ConQual approach对整合结果进行质量等级评定。结果共纳入11项研究,提炼出39个结果,归纳形成11个新类别,得出4个整合结果,分别是:护士缺乏相关认知、动机与行为技巧;患者依从性差,对医方信任度低;缺乏团队管理、方法指导与制度标准;缺乏连接共享、投入供给与上层保障。整合结果的总体证据质量等级为中级。结论现阶段护士应夯实自身能力,注重患者教育,增强医患信任感;管理者应重视团队建设、规范服务各项标准与制度;国家应加大投入力度,完善社会相关政策支持与法律保障;共为延续性护理服务的有序开展保驾护航。

Objective To systematically evaluate the quality of continuing care services carried out by nursing staff in China,comprehensively integrate the influencing factors of continuing care services,and provide guidance for promoting the development of continuing care in China.Methods PubMed,EMbase,Web of Science,the Cochrane Library,CMB,SinoMed,CINAHL,CNKI,Wanfang Data and VIP related qualitative studies were searched from the database establishment to March 2022.The NoteExpress software was used to screen and analyze the literature,the 2017 Australian JBI Evidence-based Health Care Center quality research quality evaluation standard was used to conduct qualitative evaluation of the literature,and the Meta-integration method was adopted to carry out pooled integration.The ConQual approach was used to evaluate the quality of the integrated results.Results A total of 39 results were extracted from 11 studies.Eleven new categories were summarized and four integrated results were obtained,which were:nurses lack relevant cognitive,motivational and behavioral skills;patients have poor compliance and low trust in medical prescriptions;lack of team management,method guidance and system standards;lack of connection sharing,input supply and upper protection.The total evidential quality of the integration results was intermediate.Conclusions At present,nurses should strengthen their own ability,pay attention to patient education,enhance the sense of trust between doctors and patients.Managers should pay attention to team building,standardize the service standards and systems.The state should increase input,improve social policy support and legal protection;for the orderly development of continuity of care services escort.