癌症患者及照护者对疼痛管理障碍真实体验的Meta整合

Experience of pain management barriers in cancer patients and caregivers:a Meta-synthesis of qualitative research

目的系统整合癌症患者及照护者有效疼痛管理障碍的质性研究,为患者及照护者安全有效地实施癌症疼痛管理提供参考。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、中国知网、中国生物医学文献数据库、维普数据库、万方数据库中收录的关于癌症患者及照护者参与癌症疼痛管理时经历和障碍的质性研究,检索时限为建库至2023年9月,根据澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准评价文献质量。采用汇集性整合进行Meta整合。结果共纳入9篇文献,提炼出46个研究结果,形成14个类别,进一步归纳为4个整合结果:与患者相关的疼痛管理障碍、与照护者相关的疼痛管理障碍、与医护人员相关的疼痛管理障碍、与医疗保健系统相关的疼痛管理障碍。结论多方因素造成癌症患者及照护者参与疼痛管理存在障碍,医护人员应深入了解患者的疼痛困扰,探索适用于癌症患者的疼痛管理计划和干预措施,从而降低癌症疼痛管理障碍程度。

Objective To systematically integrate the qualitative research on effective pain management disorders of cancer patients and caregivers,and to provide reference for patients and caregivers to safely and effectively implement cancer pain management.Methods The qualitative studies on the experiences and obstacles of cancer patients and caregivers in cancer pain management were retrieved from electronic databases of PubMed,Web of Science,Cochrane Library,Embase,CINAHL,China National Knowledge Infrastructure,China Biology Medicine,VIP and Wanfang data from inception to September 2023.The quality of the literature was evaluated according to Joanna Briggs Institute Evidence Based Healthcare Center Critical Appraisal Tool for qualitative studies in Australia.Meta-synthesis was used to conduct the synthesis.Results A total of 9 articles were included,and 46 research results were extracted,forming 14 categories,which were further summarized into 4 integrated results:patient-related pain management disorders,caregiver-related pain management disorders,medical staff-related pain management disorders,and health care system-related pain management disorders.Conclusions Multiple factors cause obstacles for cancer patients and caregivers to participate in pain management.Medical staff should have a deep understanding of patients′pain problems and explore pain management plans and interventions suitable for cancer patients,so as to reduce the degree of cancer pain management obstacles.