基于理论域框架的骨科大手术后病人延续护理需求的系统评价

Continuous care needs of patients after major orthopedic surgery based on theoretical domains framework:a systematic evaluation

目的:对骨科大手术后病人延续护理需求的质性研究进行系统评价和整合,全面了解病人及主要照护者、医务人员的延续护理需求。方法:检索the Cochrane Library、EMbase、Web of Science、PubMed、中国知网、维普数据库、中国生物医学文献数据库、万方数据库关于骨科大手术后病人延续护理需求的质性研究,检索年限为建立数据库至2022年6月30日。采用JBI循证卫生保健中心质性研究质量评价工具对符合要求的文献进行评价质量,采用理论域框架对提取的结果进行整合。结果:共纳入14篇文献,提炼出51个研究结果。结合理论域框架理论,将需求主题分别映射为知识、技能、结果的期望、情绪调节和环境因素5个关键领域。结论:骨科大手术后病人及主要照护者、医务人员对延续护理具有不同的需求,医护人员可在知识、技能、对结果的期望、情绪调节和环境因素5个关键领域主要需求内涵的基础上,制订有针对性的干预策略,以满足骨科大手术病人的延续护理需求并提高病人自我管理能力。

Objective:To systematically evaluate and integrate the qualitative researches on the needs of extended care after major orthopaedic surgery,and to comprehensive understand the continuing care needs of patients and primary caregivers.Methods:Qualitative studies on the needs of patients continuing care after major orthopedic surgery were searched in the Cochrane Library,EMbase,Web of Science,PubMed,CNKI,VIP,CBM,and WanFang Data,and the search period was until June 30,2022.The JBI tool was used to evaluate the quality of eligible literatures,and the theoretical domain framework was used to integrate the extracted results.Results:A total of 14 literatures were included,extracting the results of 51 studies.Combined with the theoretical domain framework theory,the above demand themes were mapped into five key areas,which were knowledge,skills,expectation of results,emotional regulation and environmental factors.Conclusion:Patients and primary caregivers after major orthopedic surgery have different needs for continuing care.On the basis of the main needs in knowledge,skills,expectation of results,emotional regulation and environmental factors,targeted intervention strategies are formulated to meet the continuous care needs of patients undergoing major orthopedic surgery and improve patients'self⁃management ability.