净化舱内造血干细胞移植患者不同治疗阶段心理体验及支持需求质性研究的Meta整合

Meta-synthesis of Qualitative Research on Psychological Experience and Support Needs of Patients with Hematopoietic Stem Cell Transplantation in Purified Cabin at Different Treatment Stages

目的系统评价净化舱内造血干细胞移植患者不同治疗阶段的心理体验及支持需求。方法计算机检索Cochrane Library、PubMed、JBI循证医疗国际合作中心、EMBase、科学网、Scopus、CINAHL、CNKI、中国生物医学文献数据库,收集有关患者心理体验及支持的文献,检索时限为建库至2023年5月,采用Meta整合法对结果进行评价。结果共纳入16项研究,提炼出31个明确的研究结果,归纳成11个类别,3个整合结果。净化舱内造血干细胞移植患者的心理历程分为3个阶段:预处理期:准备移植前恐惧、歉疚、孤独感与被抛弃感的情绪交织,更渴望得到家人的支持;极期:等待移植结果过程中的焦虑、极度恐惧与抑郁情绪交织,更希望得到专业人士、病友同伴的支持并尝试自我调适;恢复期:移植成功后希望、感恩与担忧情绪交织,迫切希望得到家人、病友同伴的支持。结论医护人员应动态关注净化舱内造血干细胞移植患者不同治疗阶段的心理体验及需求,针对患者的外在和内在需求提供支持,帮助患者尽快适应净化舱内的治疗,促进移植的顺利完成。

Objective To systematically evaluate the psychological experience and support needs of patients undergoing hematopoietic stem cell transplantation in the purified cabin at different treatment stages.Methods The Cochrane Library,PubMed,JBI International Cooperation Center for Evidence-based Medicine,EMBase,Science Network,Scopus,CINAHL,CNKI and Chinese Biomedical Literature Database were searched by computer to collect literature on patients'psychological experience and support.The retrieval time was from the establishment of the database to May 2023,and the results were evaluated by Meta-synthesis method.Results A total of 16 studies were included and 31 complete findings were grouped,summarized into 11 categories and 3 integrated results.The psychological process of patients undergoing hematopoietic stem cell transplantation in the purified cabin was divided into three stages:pre-processing period:fear,guilt,loneliness and abandonment intertwined before transplant preparation,more eager to get family support;critical period:anxiety,extreme fear and depression intertwined while waiting for transplant results,more eager to get support from professionals and fellow patients and try to adjust themselves;the convalescence period:hope,gratitude and worry intertwined after successful transplantation,eager to get support from family and fellow patients.Conclusion Healthcare workers should pay more attention to the psychological experiences and needs of hematopoietic stem cell transplantation in the purified cabin at different period of treatment,and provide help and support according to the external and internal needs of patients,help patients adapt to the treatment in the purification chamber as soon as possible,and promote the successful completion of transplantation.