医护人员参与远程居家安宁疗护体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2024.15.016

摘要/Abstract

摘要：

目的系统整合医护人员参与远程居家安宁疗护的体验，为进一步推动国内远程居家安宁疗护的开展、提升服务质量提供参考。方法计算机检索PubMed、Web of Science、CINAHL、Cochrane Library、Embase、中国知网、万方数据库、维普数据库、中国生物医学文献数据库，收集关于医护人员参与远程居家安宁疗护体验的质性研究，检索时限为建库至2023年11月。按照2016版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对纳入的文献进行质量评价，采用Meta整合方法对结果进行整合归纳。结果共纳入11篇文献，提取出40个研究结果，形成11个类别，概括为3个整合结果。①医护人员感知到参与远程居家安宁疗护的益处：提高医疗服务效率；突破时间和空间的限制；增强工作满意度；提高安宁疗护的连续性。②医护人员认识到参与远程居家安宁疗护的挑战：远程工作环境的稳定性差、设备操作复杂；理论知识和专业技能不足；患者特殊的照护需求无法满足；服务时间难以限定。③医护人员认为远程居家安宁疗护服务还需改进：重视家庭参与的重要性；将远程安宁疗护作为辅助方式；注意建立医患信任关系。结论医护人员参与远程居家安宁疗护具有诸多益处和挑战，医院管理者应为医护人员提供多方位支持，加强远程居家安宁疗护团队建设，建立线上和线下联动机制，不断提高国内远程居家安宁疗护的质量。

关键词: 安宁疗护, 远程护理, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To systematically integrate the experience of medical staff participating in remote home palliative care，and to provide a reference for further promoting the development of remote home palliative care and improving the service quality in China. Methods PubMed，Web of Science，CINAHL，Cochrane Library，Embase，CNKI，Wanfang Database，VIP Database，and Chinese Biomedical Literature Database were searched to collect qualitative studies on the experience of medical staff participating in remote home palliative care，and the search time was from inception to November 2023. The quality of the included literature was evaluated according to the 2016 edition of the Qualitative Research Quality Evaluation Criteria of the Joanna Briggs Institute for Evidence-Based Health Care in Australia，and the results were summarized by meta-synthesis method. Results A total of 11 studies were included，and 40 research results were extracted，and 11 categories were formed，which were summarized into 3 integrated results. ①Medical staff perceived the benefits of participating in remote home palliative care：improving the efficiency of medical services，breaking through the limitations of time and space，enhancing job satisfaction，and improving the continuity of palliative care. ②Medical staff recognized the challenges of participating in remote home palliative care：poor stability of remote working environment，complex equipment operation，insufficient theoretical knowledge and professional skills，inability to meet the special care needs of patients，and difficulty in defining service time. ③Medical staff believe that remote home palliative care services need to be improved：pay attention to the importance of family participation，use remote palliative care as an auxiliary method，and pay attention to establishing a doctor-patient trust relationship. Conclusion There are many benefits and challenges for medical staff to participate in remote home palliative care，and hospital managers should provide multi-faceted support for medical staff，strengthen the construction of remote home palliative care team，establish an online and offline linkage mechanism，and continuously improve the quality of remote home palliative care in China.

Key words: Palliative Care, Telenursing, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

徐雅楠, 袁玲, 武丽桂, 刘雅慧, 康玉彪. 医护人员参与远程居家安宁疗护体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(15): 1900-1907.

XU Yanan, YUAN Ling, WU Ligui, LIU Yahui, KANG Yubiao. The experience of medical staff participating in remote home palliative care：a qualitative Meta-synthesis[J]. Chinese Journal of Nursing, 2024, 59(15): 1900-1907.

图/表 3

图1 文献筛选流程

Figure 1 Literature screening process

表1 纳入文献的基本特征（n=11）

Table 1 Information of included studies（n=11）

表2 纳入文献的方法学质量评价结果（n=11）

Table 2 Methodological quality evaluation of included studies（n=11）

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