脑卒中患者虚拟现实康复体验质性研究的Meta整合

Experience of virtual reality rehabilitation of stroke patients:a Meta-synthesis of qualitative study

目的系统评价脑卒中患者虚拟现实康复体验,为临床脑卒中患者康复实践提供参考。方法检索PubMed、Web of Science、Scopus、Embase、Cochrane Library、CINAHL、中国知网、万方数据库、中国生物医学文献数据库、维普数据库中相关质性研究,检索时限为建库至2023年4月,采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心质性研究质量评价标准(2020版)进行文献质量评价,运用汇集性整合法整合结果,并采用JBI循证卫生保健中心构建的质性研究整合证据评估工具(confidence in the qualitative evidence,ConQual)对整合结果进行质量评级。结果共纳入14篇文献,提炼45个主题,归纳出10个类别,最终形成3个整合结果,即感知虚拟现实康复益处、感知虚拟现实康复障碍、对虚拟现实康复的期望和需求。ConQual评分显示,整合证据体为中等水平。结论脑卒中患者对虚拟现实康复态度积极,但未来应优化脑卒中虚拟现实康复支持系统,完善虚拟现实康复技术反馈机制和个性化内容,创新虚拟现实多功能康复模式,并推动虚拟现实康复延伸至社区和居家,促进脑卒中患者虚拟现实康复实践。

Objective To systematically review qualitative studies on the experience of virtual reality(VR)rehabilitation in stroke patients,so as to provide references for the clinical practice of stroke rehabilitation.Methods The relevant qualitative studies in PubMed,Web of Science,Scopus,Embase,Cochrane Library,CINAHL,CNKI,WanFang Data,SinoMed and VIP Database were retrieved.The retrieval time was from the establishment of the database to April 2023.The quality of included studies was evaluated according to JBI Critical Appraisal Tool(2020)for qualitative studies.Meta-synthesis was used to integrate results.Finally,the quality of evidence was evaluated by the Confidence in the Qualitative Evidence(ConQual)approach.Results A total of 14 studies were included to extract 45 research results,and 3 synthesized findings were grouped from 10 categories according to their similarities,including the perceived benefits of VR rehabilitation;the perceived barriers of VR rehabilitation;the expectations and needs for VR rehabilitation in stroke patients.The ConQual score showed a moderate quality of the synthesized findings.Conclusion Stroke patients are positive about VR rehabilitation.But in the future,we should pay attention to optimizing the VR rehabilitation support system for stroke,improving the feedback mechanism of VR rehabilitation technology,innovating VR multi-functional rehabilitation form,promoting VR rehabilitation extend to the community and home,providing a reference for the application of VR rehabilitation in stroke patients.