肺癌术后患者肺康复行为促进与障碍因素的Meta整合

doi:10.3761/j.issn.0254-1769.2025.18.017

摘要/Abstract

摘要：

目的对肺癌术后患者参与肺康复体验的质性研究进行整合，以全面了解患者参与肺康复的促进和障碍因素，为改善其肺康复依从性提供依据。方法检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、万方数据知识服务平台、维普中文期刊全文数据库、中国生物医学文献服务系统中关于肺癌术后患者参与肺康复体验的质性研究，检索年限为建库至2025年1月。采用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工具对符合要求的文献进行评价，采用理论域框架和能力、机会、动机-行为模型对提取的结果进行映射、整合。结果共纳入11篇文献，提炼出48个研究结果，基于理论域框架和能力、机会、动机-行为模型，将肺癌术后患者肺康复的促进和障碍因素分别映射、整合为14个类别，2个整合结果。结论肺癌术后患者参与肺康复受多种因素影响，临床医护人员应根据相关因素，结合患者对肺康复的态度，制订符合患者需求的肺康复计划。

关键词: 肺肿瘤, 肺康复, 影响因素分析, Meta整合, 质性研究, 循证护理学

Abstract:

Objective To synthesize qualitative studies on the experiences of postoperative lung cancer patients participating in pulmonary rehabilitation，aiming to comprehensively understand the barriers and facilitators influencing their engagement and to provide evidence-based insights for improving rehabilitation adherence. Methods Qualitative studies were retrieved from databases including Web of Science，PubMed，Cochrane Library，Embase，CNKI，Wanfang Data，VIPand Sinomed，with a search period spanning from database inception to January，2025. The methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Extracted findings were mapped and synthesized using the Theoretical Domains Framework（TDF） and the Capability-Opportunity-Motivation-Behavior mode（COM-B）. Results Ultimately，a total of 11 studies were included，yielding 48 findings. Using the Theoretical Domains Framework（TDF） and COM-B model，facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients were mapped and consolidated into 14 categories，culminating in 2 synthesized findings. Conclusion Participation in pulmonary rehabilitation among postoperative lung cancer patients is influenced by multiple factors. Clinicians should develop patient-centered pulmonary rehabilitation plans by considering these factors and incorporating patients’ attitudes and perspectives.

Key words: Lung Neoplasms, Pulmonary Rehabilitation, Root Cause Analysis, Meta-Synthesis, Qualitative Research, Evidence-Based Nursing

肖婷婷, 许丽春, 郑卉, 黄美玲, 张曼, 张铭琦. 肺癌术后患者肺康复行为促进与障碍因素的Meta整合[J]. 中华护理杂志, 2025, 60(18): 2279-2286.

XIAO Tingting, XU Lichun, ZHENG Hui, HUANG Meiling, ZHANG Man, ZHANG Mingqi. Facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients：a Meta-synthesis[J]. Chinese Journal of Nursing, 2025, 60(18): 2279-2286.

图/表 3

表1 文献检索式

Table 1 Search strategies of studies

表2 纳入文献的基本特征（n=11）

Table 2 Basic characteristics of included literature（n=11）

表3 纳入文献的方法学质量评价（n=11）

Table 3 Methodological quality appraisal of included studies（n=11）

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