助产士参与创伤性分娩体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2021.11.022

摘要/Abstract

摘要：

目的系统评价助产士参与创伤性分娩体验的质性研究,为促进助产士心理健康及助产学科发展提供参考。方法计算机检索PubMed、CINAHL、Web of Science、Scopus、Embase、SinoMed、中国社会科学引文索引、中国知网、万方和维普数据库关于助产士参与创伤性分娩体验的质性研究,检索时限为建库至2020年12月。采用澳大利亚乔安娜布里格斯研究所质性研究质量评价标准进行文献质量评价,使用汇集性整合方法对结果进行整合。结果共纳入12篇研究,提炼出104个结果,归纳形成了10个类别,综合得出4个整合结果。整合结果1：分娩创伤事件对助产士造成严重的身心及职业影响;整合结果2：助产士会采取不同的策略来应对分娩创伤事件;整合结果3：助产实践中面临多重困境,影响助产士对分娩创伤事件的体验;整合结果4：参与创伤性分娩后,助产士渴望获得心理支持。结论分娩创伤事件会给助产士造成严重影响。助产士应正视负性情绪,学会积极应对;医疗机构应合理配置产科资源,缓解助产实践面临的困境;管理者应重视助产士参与创伤性分娩的体验,提供心理支持,促进助产士的身心健康。

关键词: 助产士, 创伤性分娩, 心理体验, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To conduct a meta-synthesis of the experience of midwives’ participating in traumatic birth and to provide the evidence-based guidance for the development of midwifery. Methods 10 databases（PubMed,CINAHL,Web of Science,Scopus,Embase,SinoMed,CSSCI,CNKI,Wanfang data,VIP） were included to retrieve the literature on the experience of midwives’ participating in traumatic birth from inception until Dec 2021. The quality of included research was evaluated using the JBI Critical Appraisal Tool for qualitative studies from Australia. The results were integrated by a meta-aggregation method. Results A total of 12 studies were included,104 findings were extracted,10 categories were integrated,and 4 synthesis results were summarized. Synthesis result 1：traumatic births have serious physical,mental and professional impacts on midwives. Synthesis result 2：midwives adopt different strategies to deal with traumatic birth. Synthesis result 3：midwifery practices are faced with multiple dilemmas,which affects midwives’ experience of traumatic births. Synthesis result 4：after participating in traumatic birth,midwives are eager for psychological support. Conclusion Traumatic births have serious impacts on midwives. Midwives should face up to the negative emotions and learn to deal with them positively. Medical institutions should rationally allocate obstetric resources to alleviate the difficulties faced by midwifery practice. Managers should pay attention to midwives’ experience of participating in traumatic birth and provide psychological support to promote midwives’ physical and mental health.

Key words: Midwife, Traumatic Birth, Psychological Experience, Qualitative Study, Meta-Synthesis, Evidence-Based Nursing

代玲, 曾铁英, 张可, 袁梦梅, 王雪君. 助产士参与创伤性分娩体验质性研究的Meta整合[J]. 中华护理杂志, 2021, 56(11): 1728-1735.

DAI Ling, ZENG Tieying, ZHANG Ke, YUAN Mengmei, WANG Xuejun. The experience of midwives’ participating in traumatic birth：a meta-synthesis of qualitative research[J]. Chinese Journal of Nursing, 2021, 56(11): 1728-1735.

图/表 3

图1 PubMed检索策略

Figure 1 PubMed search strategy

表1 纳入文献的基本特征

Table 1 Basic characteristics of the included studies

表2 纳入文献的方法学质量评价结果

Table 2 Critical appraisal checklist for included studies

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