全膝关节置换术后患者康复治疗体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2023.24.013

摘要/Abstract

摘要：

目的系统评价全膝关节置换术后患者康复治疗体验，为提升其康复治疗效果和制订相关临床护理策略提供参考依据。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、Scopus、ProQuest、中国知网、万方数据库、维普数据库和中国生物医学文献数据库中关于全膝关节置换术后患者康复治疗的经历、体验、感受及需求的质性研究，检索时限为建库至2023年4月。采用2016版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进行文献质量评价，采用汇集性整合方法对研究结果进行归纳整合。结果共纳入25篇文献，提炼出82个主题，归纳为12个类别，最终形成4个整合结果：康复治疗面临多重困境，患者失去信心，急需专业的指导与监督；康复治疗中的不满意体验；感知康复治疗的益处及医护人员的鼓励，坚定康复信念；寻求理解与社会支持，正向促进康复治疗效果。结论在康复治疗过程中，医护人员应重视和反思患者面临的困境以及不满意体验，给予专业的康复指导和监督，加强与患者沟通交流，提供个性化的康复治疗。

关键词: 全膝关节置换术, 康复治疗, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To systematically evaluate the rehabilitation experience of patients after total knee arthroplasty，and to provide references for improving the effect of rehabilitation treatment and formulating related clinical nursing strategies. Methods We searched PubMed，Web of Science，the Cochrane Library，Embase，CINAHL，Scopus，ProQuest，CNKI，Wanfang database，VIP database and Chinese biomedical literature database. A qualitative study on the experiences，feelings，and needs of patients undergoing rehabilitation after total knee arthroplasty was retrieved from the database until April 2023. The quality of literature was evaluated using the Quality Evaluation Criteria of Evidence-Based Health Care Center（2016） of Joanna Briggs Institute in Australia，and the results were summarized and integrated by the aggregation integration method. Results A total of 25 studies were included；82 topics were summarized into 12 categories；4 integrated results were finally formed：rehabilitation treatment was faced with multiple difficulties，and patients lost confidence and needed professional guidance and supervision；unsatisfactory experience in rehabilitation；the perception of the benefits of rehabilitation therapy and the encouragement of medical staff，and firm faith in rehabilitation；seeking understanding and social support can promote the effect of rehabilitation therapy. Conclusion Healthcare professionals should pay attention to and reflect on the challenges and unsatisfactory experiences that patients may face during rehabilitation，and provide them with professional guidance and supervision，as well as personalized rehabilitation treatment.

Key words: Total Knee Arthroplasty, Rehabilitation Therapy, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

张文忠, 季红, 王宁, 孙康明, 李静, 徐真真, 刘翠红. 全膝关节置换术后患者康复治疗体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(24): 3028-3036.

ZHANG Wenzhong, JI Hong, WANG Ning, SUN Kangming, LI Jing, XU Zhenzhen, LIU Cuihong. Rehabilitation experience of patients after total knee arthroplasty：a qualitative meta-synthesis[J]. Chinese Journal of Nursing, 2023, 58(24): 3028-3036.

图/表 4

图1 PubMed检索策略

Figure 1 PubMed search strategies

图2 文献筛选流程

Figure 2 Literature retrieval and screening process

表1 纳入文献的基本特征（n=25）

Table 1 The basic characteristics of the included literature（n=25）

表2 纳入文献的方法学质量评价（n=25）

Table 2 Methodological quality evaluation of the included literature（n=25）

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