终末期患者营养支持决策过程质性研究的Meta整合

Qualitative research on nutritional support decision-making process for patients with end-stage disease:a Meta-synthesis

目的系统评价终末期患者营养支持决策过程中患者、家属和医护人员的感受,为改善患者及家属决策体验提供新思路。方法计算机检索Cochrane图书馆、PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库中有关终末期患者营养支持决策过程、体验的质性研究或混合研究。检索时限为建库至2023年8月。基于JBI循证卫生保健中心推荐的PICoS模型确定文献,采用MAXDQA2022软件对纳入文献进行归类整合。结果共纳入10篇文献,提炼38个主题,归纳9个类别,最终形成4个整合结果:决策者的多维度思考得出结果;决策者迫切需要专业支持;决策者认知影响决策结果;决策者同样需要心理干预。结论终末期患者营养支持决策需要经过多方协商、沟通,关注决策者心理体验,必要时给予专业支持,改善患者及家属体验。

Objective To systematically evaluate the experience of patients with end-stage disease,their families and medical staff during the nutritional support decision-making process and provides new ideas for improving decision-making experience of patients and their families.Methods A computer search was conducted for qualitative or hybrid research on nutritional support decision-making process and experience in Cochrane Library,PubMed,Web of Science,Embase,CNKI,Wanfang and VIP Database.The retrieval period ranged from the inception of the databases to August 2023.The articles were determined based on the PICoS model recommended by the JBI Evidence-based Health Care Center,and the MAXDQA2022 software was used to categorize and integrate the articles.Results A total of ten articles were included in the analysis,resulting in the refinement of 38 themes.These themes were further categorized into nine categories,allowing for the formation of four integrated results:results from multi-dimensional thinking;urgent need for professional support;decisions influenced by decision-makers’cognition,and psychological intervention for decision-makers.Conclusion The nutritional support decision-making for patients with end-stage diseases requires multi-party consultation and communication.The psychological experience of decision-makers should be taken into consideration,and professional support should be provided when needed,thus to improve the experience of patients and their families.