成年癌症患者生育力保存决策体验质性研究的Meta整合

Decision-making experience of fertility preservation in adult cancer patients:a meta-synthesis of qualitative studies

目的系统整合癌症患者生育力保存决策体验的质性研究,为辅助癌症患者做决策及改进现有决策支持体系提供循证依据。方法计算机检索PubMed、EMbase、The Cochrane Library、CINAHL、Web of Science、PsycINFO、Scopus、中国知网、万方数据库、维普数据库关于癌症患者生育力保存决策的质性研究,检索时限为建库至2022年8月。采用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评价,采用Meta整合中汇集性整合方法对结果进行整合。结果共纳入18篇文献,提炼出67个研究结果,将相似结果归纳成7个新的类别,并综合成3个整合结果:对生育力保存风险-收益的艰难权衡,紧迫决策下复杂的心理变化过程,决策过程的干扰。结论医护人员及相关卫生机构应重视癌症患者生育力保存决策的心理体验和信息需求,优化决策程序、开发决策辅助方案,促进患者尽快完成决策。

Objective To systematically integrate the qualitative research on fertility preservation(FP)decision-making experience of cancer patients,and to provide evidence-based basis for assisting cancer patients to make decisions and improve existing decision support systems.Methods Qualitative studies on FP decisions of cancer patients were retrieved through computer-assisted search in PubMed,EMbase,the Cochrane Library,CINAHL,Web of Science,PsycINFO,Scopus,CNKI,Wanfang Database and VIP database.The publication date of the studies was limited to the period from the establishment of the database to August 2022.The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies.The results were synthesized by using meta-aggregative approach.Results A total of 18 studies were included,and 67 research results were extracted.Similar results were summarized into 7 new categories,which converged to form 3 integrated results:the difficult trade-off between FP risk and benefit,complex psychological processes under urgent decisions-making,interference in the decision-making process.Conclusion Medical staff and related health institutions should pay attention to the psychological experience of cancer patients in FP decision-making,optimize decision-making procedures,and develop decision-making aids,so as to help patients to complete decision-making.