脑卒中患者居家运动康复自我决策体验的Meta整合

doi:10.3761/j.issn.0254-1769.2025.01.017

摘要/Abstract

摘要：

目的系统评价和整合脑卒中患者居家运动康复自我决策的真实体验，为进一步开展脑卒中患者自我决策支持方案提供参考。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、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脑卒中患者居家运动康复自我决策的困境、体验及相关心理感受的质性研究，检索时限为建库至2024年2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评价文献质量，用汇集性整合法进行结果整合。结果共纳入16篇文献，提炼出23个主题，归纳为10个新类别，汇合成3个整合结果：居家运动康复自我决策面临多重困境、自我决策过程中的动机转变、采取多种策略实现自我决策。结论医护人员应重视脑卒中患者自我决策的困境、动机变化与应对策略，探索患者决策优化机制，制订针对性的决策支持方案，实现居家运动康复科学化与精准化，改善患者远期康复结局。

关键词: 脑卒中, 运动康复, 自我决策, Meta整合, 循证护理学

Abstract:

Objective To systematically evaluate and integrate real experience and feelings of self-determination in home-based exercise rehabilitation of stroke patients. Methods We searched databases including PubMed，Embase，Web of Science，Cochrane Library，CINAHL，CNKI，Wanfang，VIP，Sinomed. The literature of qualitative research on self-determination experience in home-based exercise rehabilitation of stroke patients from the establishment of the database to February 2024 was retrieved. The literature was evaluated using the Australian JBI Quality Evaluation Criteria for Qualitative Research in Evidence-based Health Care Centers（2016）， and the results were consolidated using an aggregative integration approach. Results A total of 23 theme were extracted，and 10 new categories were formed after induction and integration，which were finally merged into 3 integrated results，including multiple dilemmas in rehabilitation self-determination，motivation transformation during self-determination，strategies to achieve self-determination. Conclusion During the process of home-based exercise rehabilitation for stroke patients，medical personnel should pay attention to patients’ determination dilemma，motivation changes and related strategies they adopt. Targeted decision-making programs should be developed for stroke patients，aiming for the scientific and precise advancement of exercise rehabilitation.

Key words: Stroke, Exercise Rehabilitation, Self-Determination, Meta-Synthesis, Evidence-Based Nursing

徐婕, 王清, 邵佳宁, 许文锦, 戴雨婷, 吉康菱. 脑卒中患者居家运动康复自我决策体验的Meta整合[J]. 中华护理杂志, 2025, 60(1): 121-128.

XU Jie, WANG Qing, SHAO Jianing, XU Wenjin, DAI Yuting, JI Kangling. Self-determination experience in home-based exercise rehabilitation of stroke patients：a qualitative meta-synthesis[J]. Chinese Journal of Nursing, 2025, 60(1): 121-128.

图/表 4

图1 PubMed检索策略

Figure 1 Retrieval strategy of PubMed

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=16）

Table 1 Basic features of the included literature（n=16）

表2 纳入文献的方法学质量评价结果（n=16）

Table 2 Methodological quality evaluation of the included literature（n=16）

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