妊娠期高血压疾病孕妇患病体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2022.21.014

摘要/Abstract

摘要：

目的系统评价妊娠期高血压疾病孕妇患病体验和心理感受，为制订基于证据的该类患者专病管理措施提供依据。方法计算机检索中国生物医学文献数据库、中国知网、万方数据库、维普数据库、PubMed、Cochrane Library、Web of Science、Embase、PsycINFO、Proquest、CINAHL数据库中关于妊娠期高血压疾病孕妇患病经历、心理体验和感受的质性研究，检索时限为建库至2021年11月10日。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标准对文献质量进行评价，采用汇集性整合法对研究结果进行归纳整合。结果共纳入16篇文献，提炼60个主题，归纳12个类别，形成4个整合结果：情感反应复杂且持久、打破妊娠的常态、寻求理解与支持、疾病经历中的获益和成长。结论医护人员应加强对妊娠期高血压疾病孕妇心理健康的动态评估，通过协调、连续的孕产期保健服务，促进医护-家庭-自我多元应对系统的建立，增强该类孕妇的妊娠控制感，降低疾病因素对其妊娠结局及心理健康的不良影响，保障母婴安全。

关键词: 妊娠期高血压疾病, 体验, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To systematically evaluate the disease experience and psychological feeling of pregnant women with hypertensive disorders of pregnancy，and to provide the evidence for disease management measures for pregnant women with hypertensive disorders of pregnancy. Methods Chinese and English databases，including SinoMed，CNKI，Wanfang，VIP，PubMed，Cochrane Library，Web of Science，Embase，PsycINFO，Proquest，CINAHL，were searched for qualitative studies on real experience of hypertensive disorders of pregnancy in pregnant women from the inception of databases to November 10th 2021. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods. Results 16 studies were included in the final review. Totally 60 findings were extracted;12 new categories were generated;4 integrated results were synthesized as following，complex and lasting emotional response，breaking the pregnancy norm，seeking understanding and support，finding the benefits from experience. Conclusion Nurses should strengthen the dynamic assessment of the mental health of pregnant women with hypertensive disorders of pregnancy，promote the establishment of a multi-coping system of medical care-family-self through coordinated and continuous maternal health care services，enhance the sense of pregnancy control of such pregnant women，reduce the adverse effects of disease factors on pregnancy outcomes and mental health，and ensure the safety of mothers and infants.

Key words: Hypertensive Disorders of Pregnancy, Experience, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

蒲丛珊, 樊雪梅, 夏家爱, 张莹莹, 龙伟, 周晖. 妊娠期高血压疾病孕妇患病体验质性研究的Meta整合[J]. 中华护理杂志, 2022, 57(21): 2644-2651.

PU Congshan, FAN Xuemei, XIA Jiaai, ZHANG Yingying, LONG Wei, ZHOU Hui. The real experience of hypertensive disorders of pregnancy in pregnant women：a qualitative meta-synthesis[J]. Chinese Journal of Nursing, 2022, 57(21): 2644-2651.

图/表 2

参考文献 34

[1]	中华医学会心血管病学分会女性心脏健康学组, 中华医学会心血管病学分会高血压学组. 妊娠期高血压疾病血压管理专家共识(2019)[J]. 中华心血管病杂志, 2020, 48(3):195-204.
	Women’s Heart Health Group of Chinese Society of Cardiology of Chinese Medical Association,Hypertension Group of Chinese Society of Cardiology of Chinese Medical Association. Expert consensus on blood pressure management in hypertensive disorders of pregnancy(2019)[J]. Chin J Cardiol, 2020, 48(3):195-204.
[2]	ACOG. Practice bulletin No. 202:gestational hypertension and preeclampsia[J]. Obstetr Gynecol, 2019, 133(1):220-224. DOI URL
[3]	颜雪梅, 孔繁娟, 王爱华, 等. 6579例妊娠期高血压疾病孕产妇的患病情况及发生危重情况的影响因素[J]. 中南大学学报(医学版), 2021, 46(8):814-821.
	Yan XM, Kong FJ, Wang AH, et al. Prevalence and the influencing factors for critical situation of 6 579 pregnant women with hypertensive disorders complicating pregnancy[J]. J Central South Univ Med Sci, 2021, 46(8):814-821.
[4]	Prick BW, Bijlenga D, Jansen AJG, et al. Determinants of health-related quality of life in the postpartum period after obstetric complications[J]. Eur J Obstet Gynecol Reproductive Biol, 2015, 185:88-95. DOI URL
[5]	van Esch JJA, Bolte AC, Vandenbussche FPHA, et al. Differences in hair cortisol concentrations and reported anxiety in women with preeclampsia versus uncomplicated pregnancies[J]. Pregnancy Hypertens, 2020, 21:200-202. DOI PMID
[6]	Raina J, El-Messidi A, Badeghiesh A, et al. Pregnancy hypertension and its association with maternal anxiety and mood disorders:a population-based study of 9 million pregnancies[J]. J Affect Disord, 2021, 281:533-538. DOI URL
[7]	胡雁. 循证护理学[M]. 北京: 人民卫生出版社, 2012:130-141.
	Hu Y. Evidence-based nursing[M]. Beijing: People’s Medical Pub-lishing House, 2012:130-141.
[8]	Cowan J. Women’s experience of severe early onset preeclampsia:a hermeneutic analysis[D]. Auckland university, 2005.
[9]	Lima de Souza N, Fernandes Araújo AC, Dantas de Azevedo G, et al. Maternal perception of premature birth and the experience of pre-eclampsia pregnancy[J]. Rev Saude Publica, 2007, 41(5):704-710. DOI URL
[10]	Fleury C, Parpinelly M, Makuch MY. Development of the mo-ther-child relationship following pre-eclampsia[J]. J Reproductive Infant Psychol, 2010, 28(3):297-306. DOI URL
[11]	Kehler S, Ashford K, Cho M, et al. Experience of preeclampsia and bed rest:mental health implications[J]. Issues Ment Heal Nurs, 2016, 37(9):674-681.
[12]	Mukwenda AM, Mbekenga CK, Pembe AB, et al. Women’s experiences of having had,and recovered from,eclampsia at a tertiary hospital in Tanzania[J]. Women Birth, 2017, 30(2):114-120. DOI URL
[13]	Vaerland IE, Vevatne K, Brinchmann BS. Mothers’ experiences of having a premature infant due to pre-eclampsia[J]. Scand J Caring Sci, 2018, 32(2):527-534. DOI PMID
[14]	Roberts LM, Davis GK, Homer CSE. Pregnancy with gestational hypertension or preeclampsia:a qualitative exploration of women’s experiences[J]. Midwifery, 2017, 46:17-23. DOI PMID
[15]	王祖娴, 曹卫平. 妊娠期高血压病人心理需求的质性研究[J]. 全科护理, 2019, 17(9):1119-1122.
	Wang ZX, Cao WP. A qualitative study on the psychological needs of gestational hypertension patients[J]. Chin Gen Pract Nurs, 2019, 17(9):1119-1122.
[16]	Duffy J, Thompson T, Hinton L, et al. What outcomes should researchers select,collect and report in pre-eclampsia research?A qualitative study exploring the views of women with lived experience of pre-eclampsia[J]. BJOG, 2019, 126(5):637-646. DOI URL
[17]	Sripad P, Kirk K, Adoyi G, et al. Exploring survivor perceptions of pre-eclampsia and eclampsia in Nigeria through the health belief model[J]. BMC Pregnancy Childbirth, 2019, 19(1):431. DOI URL
[18]	黄莺莺, 曹卫平, 韦嘉洁, 等. 妊娠期高血压疾病患者患病体验的质性研究[J]. 护理学报, 2020, 27(10):5-9.
	Huang YY, Cao WP, Wei JJ, et al. Qualitative study on illness experiences of hypertensive disorders in pregnancy[J]. J Nurs Chin, 2020, 27(10):5-9.
[19]	Mooij R, Kapanga RR, Mwampagatwa IH, et al. Beyond severe acute maternal morbidity:a mixed-methods study on the long-term consequences of(severe pre) eclampsia in rural Tanzania[J]. Trop Med Int Health, 2021, 26(1):33-44. DOI PMID
[20]	Dempsey A, Sripad P, Sultana K, et al. Pathways to service access for pre-eclampsia and eclampsia in rural Bangladesh:exploring women’s care-seeking[J]. PLoS One, 2021, 16(2):e0245371. DOI URL
[21]	Carter W, Bick D, MacKintosh N, et al. Maternal help seeking about early warning signs and symptoms of pre-eclampsia:a qualitative study of experiences of women and their families[J]. Midwifery, 2021, 98:102992. DOI URL
[22]	Andersson M, Rubertsson C, Hansson S. The experience of provided information and care during pregnancy and postpartum when diagnosed with preeclampsia:a qualitative study[J]. Eur J Midwifery, 2021, 5:1-9.
[23]	Helou A, Stewart K, Ryan K, et al. ‘I wish my body was stro-nger’:a qualitative study of attitudes and behaviours regarding treatment of hypertensive disorders of pregnancy[J]. SAGE Open Med, 2021, 9:20503121211032480.
[24]	Camacho-Arroyo I, Flores-Ramos M, Mancilla-Herrera I, et al. Chemokine profile in women with moderate to severe anxiety and depression during pregnancy[J]. BMC Pregnancy Childbirth, 2021, 21(1):807. DOI URL
[25]	Caropreso L, de Azevedo Cardoso T, Eltayebani M, et al. Pree-clampsia as a risk factor for postpartum depression and psychosis:a systematic review and meta-analysis[J]. Arch Womens Ment Health, 2020, 23(4):493-505. DOI PMID
[26]	Ye Y, Chen L, Xu JN, et al. Preeclampsia and its complications exacerbate development of postpartum depression:a ret-rospective cohort study[J]. Biomed Res Int, 2021, 2021:6641510.
[27]	Szita B, Baji I, Rigó J Jr. Psychosocial aspects of preeclampsia[J]. Orv Hetil, 2015, 156(50):2028-2034. DOI URL
[28]	Roberts L, Henry A, Harvey SB, et al. Depression,anxiety and posttraumatic stress disorder six months following preeclampsia and normotensive pregnancy:a P4 study[J]. BMC Pregna-ncy Childbirth, 2022, 22(1):108.
[29]	漆洪波, 胡小靖. 妊娠期高血压疾病产前保健的“六个重视”[J]. 中国实用妇科与产科杂志, 2021, 37(5):512-514. DOI
	Qi HB, Hu XJ. Six focuses in prenatal health care for hypertensive disorders in pregnancy[J]. Chin J Pract Gynecol Obstet, 2021, 37(5):512-514.
[30]	Cairns AE, Tucker KL, Crawford C, et al. Implementing self-management:a mixed methods study of women’s experiences of a postpartum hypertension intervention(SNAP-HT)[J]. Trials, 2020, 21(1):508. DOI URL
[31]	周临, 张晶, 陈丹丹, 等. 以家庭为中心的群组式孕期保健模式的应用及效果研究[J]. 中华护理杂志, 2019, 54(3):401-405. DOI
	Zhou L, Zhang J, Chen DD, et al. The application and effects of family-centered group prenatal care model[J]. Chin J Nurs, 2019, 54(3):401-405. DOI
[32]	燕美琴, 王娇, 刘亦娜, 等. 群组孕期保健模式在妊娠期糖尿病孕妇分娩结局中的效果研究[J]. 中华护理杂志, 2021, 56(9):1305-1311. DOI
	Yan MQ, Wang J, Liu YN, et al. Observation on the effect of group health care model during pregnancy in childbirth outcome of pregnant women with gestational diabetes[J]. Chin J Nurs, 2021, 56(9):1305-1311. DOI
[33]	Shree R, Hatfield-Timajchy K, Brewer A, et al. Information needs and experiences from pregnancies complicated by hypertensive disorders:a qualitative analysis of narrative responses[J]. BMC Pregnancy Childbirth, 2021, 21(1):743. DOI URL
[34]	弓少华, 孙超, 杨姮, 等. 中青年脑卒中患者疾病体验的Meta整合[J]. 中华护理杂志, 2021, 56(6):843-851. DOI
	Gong SH, Sun C, Yang H, et al. The real experience of stroke patients in young and middle-age adults:a qualitative meta-synthesis[J]. Chin J Nurs, 2021, 56(6):843-851.