慢性肾病患者及其照护者家庭血液透析体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2023.11.014

摘要/Abstract

摘要：

目的系统整合关于慢性肾病患者及其照护者对家庭血液透析（home hemodialysis，HHD）的体验的质性研究。方法检索中国知网、万方数据库、维普数据库、PubMed、Embase、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、CINAHL、Web of Science、ProQuest学位论文数据库、Scopus数据库中的相关研究。检索时限为建库至2022年7月15日，根据JBI循证卫生保健中心质性研究质量评价标准评价文献质量。采用汇集性整合进行Meta整合。结果共纳入11篇文献，提取116个明确的研究结果，归纳相近的研究结果形成12个类别，4个整合结果：适应HHD的过程；学习HHD技术的过程；自身和家庭的困难；感知HHD的灵活性。结论在慢性肾病患者进行HHD治疗初始阶段，应关注患者对HHD的态度变化，引导患者适应和接受HHD技术，结合患者信息获取特点和个性化要求向患者及照护者提供HHD培训，同时护士需要关注照护者的照护负担，克服HHD应用时的阻碍因素，促进HHD在国内的应用与发展。

关键词: 慢性肾病, 血液透析, 家庭, 体验, 质性研究, Meta整合, 系统评价

Abstract:

Objective To conduct a meta-synthesis of the experience of patients with chronic kidney disease and their caregivers on home hemodialysis（HHD） and provide evidence-based guidance for the development and implementation of HHD in patients with chronic kidney disease. Methods 10 databases（CNKI，Wanfang database，VIP database，Pubmed，Embase，JBI evidence-based database，CINAHL，Web of Science，ProQuest，and Scopus） were included to retrieve the literature on the experience of patients with chronic kidney disease and their caregivers on HHD from inception to July 2022. The quality of the literature was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. Meta-synthesis was used to conduct the synthesis. Results 116 findings were extracted from 11 qualified studies，and similar research results were integrated into 12 categories. Finally，4 synthesized results were summarized：the process of adapting themselves to HHD，the process of training before HHD，personal and family difficulties，perceiving the flexibility of HHD. Conclusion At the beginning of HHD，more attention should be paid to the change of patient attitude and experience on HHD. Patients should be guided to adapt and accept HHD technology. Appropriate training concerning the characteristics of patients’ access to information and personalized requirements should be provided. Nurses need to focus on the care burden of caregivers and overcome the barriers of HHD to promote the implementation and development of HHD in China.

Key words: Chronic Kidney Disease, Hemodialysis, Home, Experience, Qualitative Research, Meta-Synthesis, Systematic Review

郑旭彤, 林晓忆, 秦朱珠, 陈丹凤, 叶欣欣, 王周华, 詹陈菊. 慢性肾病患者及其照护者家庭血液透析体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(11): 1365-1371.

ZHENG Xutong, LIN Xiaoyi, QIN Zhuzhu, CHEN Danfeng, YE Xinxin, WANG Zhouhua, ZHAN Chenju. The experience of chronic kidney disease and their caregivers in home hemodialysis：a meta-synthesis of qualitative research[J]. Chinese Journal of Nursing, 2023, 58(11): 1365-1371.

图/表 3

图1 文献检索及筛选流程

Figure 1 Literature retrieval and screening process

表1 纳入文献的基本特征（n=11）

Table 1 Characteristics 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 appraisal of included literature（n=11）

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