癌症患者及家属参与预立医疗照护计划体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2020.12.019

摘要/Abstract

摘要：

目的系统整合关于癌症患者及其家属参与预立医疗照护计划（advance care planning,ACP）体验的质性研究,为ACP在癌症患者中的应用和发展提供循证依据。方法运用PICo模型构建研究问题和纳入、排除标准;计算机检索Embase、Medline、PsycINFO、CINAHL、Cochrane Library、中国学术期刊全文数据库和中国生物医学文献数据库,检索癌症患者及家属参与ACP体验的质性研究,检索时限为建库至2020年2月。采用乔安娜布里格斯研究所质性研究质量评价工具（2017）对文献进行方法学的质量评价,并运用汇集性Meta整合的方法对结果进行整合。结果共纳入8篇文献,提取47个研究发现,并归纳成5个类别和2个研究整合。整合结果一：灵活、个性化的ACP能给患者带来切实的益处;整合结果二：癌症患者及家属在ACP中面临着来自自身、家庭和社会的困难。结论 ACP是一个复杂的过程,受多种因素的影响,需要多方面人员共同努力才能获得高质量的ACP沟通。

关键词: 预立医疗照护计划, 癌症, 体验, 质性研究, Meta整合

Abstract:

Objective To conduct a meta-synthesis of the experience of cancer patients and their relatives in advance care planning （ ACP ） and provide evidence-baced guidance for the development and implementation of ACP in cancer patients. Methods The research question,inclusion and exclusion criteria were constructed by PICo model. 6 databases（ Embase, MEDLINE, PsycINFO, CINAHL, Cochrane library CNKI, CMB ） were included to retrieve literature on the experience of cancer patients and their relatives about ACP intervention from inception until Feb 2020. The JBI Critical Appraisal Tool for qualitative studies from Australia was used to evaluate the methodology quality of included research. Meta-aggregation was used to conduct the synthesis. Results 47 findings were extracted from 8 qualified studies and integrated into 5 categories. 2 synthesis results were summarized from the 5 categories. Synthesis result 1：Patients benefit from individual and flexible ACP strategy;Synthesis result 2：Barriers to ACP come from patients themselves,their family members and the cultural background of their society. Conclusion ACP is a complex social process and influenced by many factors. It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.

Key words: Advance Care Planning, Cancer, Experience, Qualitative Research, Meta-Synthesis

邓志坚,陈相应,杨柳,张江辉,邓仁丽. 癌症患者及家属参与预立医疗照护计划体验质性研究的Meta整合[J]. 中华护理杂志, 2020, 55(12): 1864-1870.

DENG Zhijian,CHEN Xiangying,YANG Liu,ZHANG Jianghui,DENG Renli. The experience of cancer patients and their relatives in advance care planning：a meta-synthesis of qualitative research[J]. Chinese Journal of Nursing, 2020, 55(12): 1864-1870.

图/表 3

图1 文献检索及筛选流程注：CMB为中国生物医学文献数据库;CNKI为中国学术期刊全文数据库

Figure 1 Literature screening and retrieval process

表1 纳入文献的JBI质性研究质量评价结果

Table 1 JBI Critical appraisal checklist for qualitative research

表2 纳入文献的资料提取结果

Table 2 Imformation of included studies

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