先天性心脏病青少年向成人过渡治疗及护理体验的Meta整合

doi:10.3761/j.issn.0254-1769.2024.02.014

摘要/Abstract

摘要：

目的系统评价先天性心脏病（congenital heart disease，CHD）青少年向成人过渡治疗及护理体验的质性研究，为制订CHD青少年向成人过渡治疗及护理管理方案提供参考。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、EBSCO、CINAHL、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于CHD青少年向成人过渡治疗及护理体验的质性研究，检索时限为建库至2023年4月。使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（2016）评价文献质量，采用Meta整合方法对结果进行整合。结果共纳入9篇文献，提炼出49个研究结果，最终归纳为11个类别，综合为4个整合结果。①态度复杂，依恋和期待并存：依恋儿科医疗机构；期待过渡到成人医疗机构。②面临多种挑战：缺乏充分的向成人过渡的准备；父母退出疾病管理者角色；儿科、成人医疗机构的服务存在较大差异。③期望获得多种支持：期望获得医护人员全面的健康教育；期待医疗机构设立咨询门诊、实现病情交接；期望获得父母的陪伴和支持；期望获得同伴的理解和帮助。④感知到向成人过渡的益处：疾病管理能力增强；角色改变和个人成长。结论 CHD青少年向成人过渡治疗及护理体验复杂，医护人员应关注其感受，鼓励其积极应对挑战，提供充足的信息，并联合父母及同伴给予支持，以促进青少年向成人顺利过渡。

关键词: 先天性心脏病, 青少年, 过渡, 质性研究, Meta整合, 儿科护理学

Abstract:

Objective To systematically evaluate qualitative studies on the experience of transition from adolescent to adult medical care for patients with congenital heart disease（CHD），and to provide a reference for exploring CHD transition management options and developing intervention strategies. Methods A computerized search of PubMed，Embase，Web of Science，Cochrane Library，EBSCO，CINAHL，China Knowledge Network，Wanfang database，Vipshop database，and China Biomedical Literature Database for qualitative studies on the transition experience of CHD patients from adolescence to adult medical care was conducted for the period from the establishment of the database to April 2023. The quality of the literature was evaluated using the Joanna Briggs Institute（JBI） Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research（2016），and the results were integrated using meta-integration methods. Results A total of 9 studies were included，and 49 research results were extracted，and 11 categories were summarized. The final synthesis included 4 integrated results：①Complex attitudes towards healthcare transition，with both attachment and expectation：attachment to paediatric healthcare providers，expectation of transition to adult healthcare providers. ②Facing multiple healthcare transition challenges：lack of adequate preparation for healthcare transition，parents withdrawing from the role of disease manager，large differences in services between paediatric and adult healthcare providers. ③Expect to receive multiple supports：expect to receive comprehensive health education from healthcare personnel，expect healthcare institutions to set up healthcare transition counselling clinics and achieve handover of illness，expect to receive companionship and support from parents，expect to receive understanding and help from peers. ④Per-ceived benefits of medical transition：increased ability to manage illness，role change and personal growth. Conclusion Adolescents with CHD have a complex experience of transitioning to adult healthcare，and healthcare professionals should be attentive to their feelings，encourage them to deal with challenges positively，and provide adequate information and joint parental and peer support to facilitate a smooth transition to adult healthcare for adolescents.

Key words: Congenital Heart Disease, Adolescents, Transition, Qualitative Study, Meta-Integration, Pediatric Nursing

于万慧, 崔朝妹, 迟嘉婧, 靳子恒, 苟晓瑜, 李梦洁, 卢楠, 杨丽娟. 先天性心脏病青少年向成人过渡治疗及护理体验的Meta整合[J]. 中华护理杂志, 2024, 59(2): 219-227.

YU Wanhui, CUI Zhaomei, CHI Jiajing, JIN Ziheng, GOU Xiaoyu, LI Mengjie, LU Nan, YANG Lijuan. Experience of medical transition from adolescents with congenital heart disease to adults：a meta-synthesis of qualitative research[J]. Chinese Journal of Nursing, 2024, 59(2): 219-227.

图/表 5

图1 PubMed的检索式

Figure 1 PubMed search query

图2 文献筛选流程

Figure 2 Literature screening process

表1 纳入文献的基本特征（n=9）

Table 1 Basic characteristics of included studies（n=9）

表2 纳入文献的方法学质量评价（n=9）

Table 2 Methodological quality evaluation of included studies（n=9）

表3 先天性心脏病青少年向成人过渡治疗及护理体验Meta整合结果分级

Table 3 Evidence reliability rating of transition experience from congenital heart defect adolescents to adults

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