早发型痴呆患者配偶照顾者照护体验的Meta整合

Caregiving experience of spouse caregivers of patients with Young-Onset Dementia:a Meta-synthesis

目的:系统整合早发型痴呆患者配偶照顾者照护体验的质性研究,为制定满足配偶照顾者内心需求的干预措施提供参考。方法:计算机检索中英文数据库,纳入关于早发型痴呆患者配偶照顾者照护体验的质性研究,检索时限均为建库至2024年3月。采用澳大利亚JBI循证卫生保健中心质性研究文献质量评价工具对文献质量进行评价,运用汇集性整合方法对结果进行整合。结果:共纳入9篇研究,提炼出34个明确的研究结果,归纳形成9个新类别,综合出4个整合结果:严重的痴呆症状与复杂的诊断心理过程;沉重的照顾负担与巨大的心理社会压力;积极应对与个人成长;复杂需求与多元支持。结论:早发型痴呆患者配偶照顾者难以管理早发型痴呆患者的异常精神行为症状、承担沉重的照顾负担、存在强烈负性情绪、渴望获得多元化的支持,但也能够积极应对困境。医院及社区医护人员应高度重视早发型痴呆患者配偶照顾者的心理体验和需求,并给予个性化干预措施,提升早发型痴呆患者及其配偶的生活质量。

Objective:To systematically integrate qualitative studies on the caregiving experiences of spouse caregivers of patients with Young-Onset Dementia(YOD)to provide a reference for the development of interventions to meet the inner needs of spouse caregivers.Methods:Chinese and English databases were searched to include qualitative studies on the caregiving experience of spouse caregivers of patients with YOD.The search time frame was from the inception to March 2024.The literature was evaluated using the quality assessment tool for qualitative research developed by Australian JBI Centre for Evidence-Based Health Care.The results were integrated using integrative synthesis method developed by JBI.Results:A total of 9 studies were included to extract 34 findings,which were summarized into nine categories and four integrated themes,namely,serious symptoms and complex diagnostic problems,heavy caregiving burden and significant psychosocial stress,active coping and personal growth,and diversified needs and support.Conclusion:Spouse caregivers of patients with YOD had difficulties in managing abnormal psycho-behavioral symptoms.They had high caregiving burden,strong negative emotions,and desire for various support.Meanwhile,they reacted positively to their predicament.Hospitals and community health care workers should give high priority to the psychological experiences and needs of spouse caregivers of patients with YOD and provide individualized interventions to enhance the quality of life of patients with YOD and their spouses.