慢性阻塞性肺疾病患者吸入药物治疗体验的Meta整合

doi:10.3761/j.issn.0254-1769.2025.05.005

摘要/Abstract

摘要：

目的系统评价慢性阻塞性肺疾病患者吸入药物治疗体验的质性研究，为医护人员优化照护策略提供参考。方法系统检索国内外数据库中收录的关于慢性阻塞性肺疾病患者吸入药物治疗体验的质性研究，检索时限为建库至2024年9月。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文献质量评价标准对文献质量进行评价，采用汇集性整合方法对结果进行整合。结果共纳入12篇文章，提炼出84个原始研究结果，归纳为10个新类别，形成4个整合结果：药物素养水平较低、药物疗效感知有差异、用药存在多重负担、吸入药物治疗需要多维度支持。结论慢性阻塞性肺疾病患者在吸入药物治疗过程中存在多重体验，医护人员应加强用药教育，提升患者的药物认知与用药技能，帮助其树立积极的治疗态度，并整合多方资源，改善其吸入药物的治疗体验。

关键词: 肺疾病，慢性阻塞性, 吸入治疗, 体验, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To systematically evaluate qualitative studies on the experience of inhalation therapy for patients with chronic obstructive pulmonary disease（COPD），in order to provide a basis for healthcare professionals to optimize the care strategies. Methods A systematic search was conducted for qualitative studies on the experience of inhalation therapy for patients with COPD included in domestic and international databases，with a timeframe from the establishment of the database to September 2024. Literature quality was evaluated using the Australian JBI Centre for Evidence-Based Health Care Literature Quality Assessment Criteria for Qualitative Research，and the results were integrated by a pooled integration approach. Results A total of 12 articles were included，and 84 original findings were extracted and summarized into 10 new categories to form 4 integrated results，including low level of drug literacy，differences in perceived efficacy，multiple medication burdens，and multi-dimensional support for inhalation therapy. Conclusion COPD patients have multiple experiences during inhalation therapy. Medical staff should strengthen drug education，enhance patients’ cognition and medication skills，foster a positive treatment attitude，and integrate multiple resources to improve patients’ inhalation therapy experience.

Key words: Pulmonary Disease，Chronic Obstructive, Inhalation Therapy, Experience, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

王雯静, 郝妩媚, 台靖宇, 董倩, 郭爱敏. 慢性阻塞性肺疾病患者吸入药物治疗体验的Meta整合[J]. 中华护理杂志, 2025, 60(5): 545-551.

WANG Wenjing, HAO Wumei, TAI Jingyu, DONG Qian, GUO Aimin. Experience of inhalation therapy in patients with chronic obstructive pulmonary disease：a Meta-synthesis[J]. Chinese Journal of Nursing, 2025, 60(5): 545-551.

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参考文献 32

[1]	Hurst JR, Siddiqui MK, Singh B, et al. A systematic literature review of the humanistic burden of COPD[J]. Int J Chron Obstruct Pulmon Dis, 2021,16:1303-1314.
[2]	中国医学装备协会呼吸病学装备技术专业委员会, 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,广东省药学会. 稳定期慢性阻塞性肺疾病医药共管专家共识[J]. 中华结核和呼吸杂志, 2022, 45(10):980-987.
	Respiratory Equipment Technical Committee of China Association of Medical Equipment Chronic Obstructive Pulmonary Disease Group of Chinese Thoracic Society, Chronic Obstructive Pulmonary Disease Group of Respiratory Disease Branch of Chinese Medical Association, Guangdong Pharmaceutical Association. Expert consensus on physician-pharmacist collabo-rative management of stable chronic obstructive pulmonary disease[J]. Chin J Tuberc Respir Dis, 2022, 45(10):980-987.
[3]	Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease(2021 report)[EB/OL]. (2020-11-18)[2024-12-29]. http://goldcopd.org/archived-report/.
[4]	Woo S, Veliz P, Saint Arnault DM, et al. Development and preliminary psychometric evaluation of the COPD-related Stigma Scale[J]. Heart Lung, 2023,61:22-28.
[5]	赵茜, 钮美娥, 吴振云. 呼吸系统疾病患者正确掌握药物吸入技术的研究进展[J]. 中华护理杂志, 2021, 56(9):1426-1430. DOI
	Zhao Q, Niu ME, Wu ZY. Research progress on factors affecting the accuracy of drug inhalation techniques in patients with respiratory diseases[J]. Chin J Nurs, 2021, 56(9):1426-1430. DOI
[6]	Plaza V, Giner J, Curto E, et al. Determinants and differences in satisfaction with the inhaler among patients with asthma or COPD[J]. J Allergy Clin Immunol Pract, 2020, 8(2):645-653. DOI PMID
[7]	Stolbrink M, Thomson H, Hadfield RM, et al. The availability,cost,and affordability of essential medicines for asthma and COPD in low-income and middle-income countries:a systema-tic review[J]. Lancet Glob Health, 2022, 10(10):e1423-e1442.
[8]	Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD[J]. Int J Chron Obstruct Pulmon Dis, 2008, 3(3):371-384. DOI PMID
[9]	胡雁. 如何开展质性研究的系统评价和Meta整合[J]. 上海护理, 2020, 20(7):1-5.
	Hu Y. How to carry out systematic review and meta-synthesis of qualitative studies[J]. Shanghai Nurs, 2020, 20(7):1-5.
[10]	Ma J, Sun X, Wang XW, et al. Factors affecting patient adherence to inhalation therapy:an application of SEIPS model 2.0[J]. Patient Prefer Adherence, 2023,17:531-545.
[11]	Padmanabhan M, Kadhiravan T, Rajaram M, et al. A panoramic view of patients’ beliefs and knowledge about chronic respiratory disease[J]. Cureus, 2022, 14(11):e31633.
[12]	O’Toole J, Krishnan M, Riekert K, et al. Understanding barriers to and strategies for medication adherence in COPD:a qualitative study[J]. BMC Pulm Med, 2022, 22(1):98.
[13]	王艳, 周欣宇, 李欣欣, 等. 慢性阻塞性肺疾病患者长期使用干粉吸入剂的心理体验[J]. 中国社区医师, 2021, 37(4):176-177.
	Wang Y, Zhou XY, Li XX, et al. Psychological experience of long time of using dry powder inhalation in patients with chronic obstructive pulmonary disease[J]. Chin Comm Doc, 2021, 37(4):176-177.
[14]	张春霞, 余燕娥, 庄耀宁, 等. 慢性阻塞性肺疾病患者吸入给药治疗自我体验的质性探究[J]. 莆田学院学报, 2020, 27(2):34-39.
	Zhang CX, Yu YE, Zhuang YN, et al. Qualitative study on self-experience of patients with chronic obstructive pulmonary disease treated by inhalation[J]. J Putian Univ, 2020, 27(2):34-39.
[15]	Gilworth G, Harries T, Corrigan C, et al. Perceptions of COPD patients of the proposed withdrawal of inhaled corticosteroids prescribed outside guidelines:a qualitative study[J]. Chron Respir Dis, 2019,16:1479973119855880.
[16]	Svedsater H, Doll HA, Macey J, et al. Evaluating the impact and benefits of fluticasone furoate/vilanterol in individuals with asthma or COPD:a mixed-methods analysis of patient experiences[J]. Adv Ther, 2018, 35(9):1378-1399. DOI PMID
[17]	Koehorst-Ter Huurne K, Brusse-Keizer M, van der Valk P, et al. Patients with underuse or overuse of inhaled corticosteroids have different perceptions and beliefs regarding COPD and inhaled medication[J]. Patient Prefer Adherence, 2018,12:1777-1783.
[18]	Alhomoud F. The use of multiple inhalation devices for chronic obstructive pulmonary disease:a study of older patients in primary care[D]. London, UK: University College London, 2014.
[19]	Svedsater H, Dale P, Garrill K, et al. Qualitative assessment of attributes and ease of use of the ELLIPTA? Dry powder inhaler for delivery of maintenance therapy for asthma and COPD[J]. BMC Pulm Med, 2013,13:72.
[20]	卿泉, 谢桂珍, 蒋振华, 等. 影响中重度慢性阻塞性肺疾病患者吸入治疗依从性的质性研究[J]. 护士进修杂志, 2010, 25(23):2176-2178.
	Qing Q, Xie GZ, Jiang ZH, et al. Qualitative study of the compliance inhalation treatment for patients with moderate to severe chronic obstructive pulmonary disease[J]. J Nurses Train, 2010, 25(23):2176-2178.
[21]	Jones RC, Hyland ME, Hanney K, et al. A qualitative study of compliance with medication and lifestyle modification in chro-nic obstructive pulmonary disease(COPD)[J]. Prim Care Respir J, 2004, 13(3):149-154.
[22]	彭博, 张小娟, 姜骁桐, 等. 基层医疗卫生机构慢性阻塞性肺疾病基本药物与诊断设备可获得性调查研究[J]. 中国全科医学, 2022, 25(7):771-781.
	Peng B, Zhang XJ, Jiang XT, et al. The availability of essen-tial medicines and diagnostic devices for chronic obstructive pulmonary disease in primary care[J]. Chin Gen Pract, 2022, 25(7):771-781.
[23]	彭咏怡, 陈树冰, 吴仲平, 等. 慢性气道疾病患者使用吸入药物装置的技术水平及其影响因素[J]. 国际呼吸杂志, 2023, 43(4):434-441.
	Peng YY, Chen SB, Wu ZP, et al. Inhaler devices usage technical level and influencing factors in patients with chronic airway diseases[J]. Int J Respir, 2023, 43(4):434-441.
[24]	Sriram KB, Percival M. Suboptimal inhaler medication adherence and incorrect technique are common among chronic obstructive pulmonary disease patients[J]. Chron Respir Dis, 2016, 13(1):13-22.
[25]	Kim YM, Yu M, Moon HR, et al. Effects of a tailored inhaler use education program for chronic obstructive pulmonary disease patients[J]. Patient Educ Couns, 2020, 103(4):717-723. DOI PMID
[26]	赵茜, 钮美娥, 韩燕霞, 等. COPD患者吸入剂使用指导严肃游戏的开发与评价[J]. 护理学杂志, 2023, 38(23):98-102.
	Zhao Q, Niu ME, Han YX, et al. Development and usability assessment of serious game featuring inhalant use guidance for COPD patients[J]. J Nurs Sci, 2023, 38(23):98-102.
[27]	黄聪, 谌永毅, 刘翔宇, 等. 移动医疗在护理领域的应用进展[J]. 中华护理杂志, 2019, 54(8):1264-1268. DOI
	Huang C, Chen YY, Liu YX, et al. Progress in the application of mobile healthcare in the field of nursing[J]. Chin J Nurs, 2019, 54(8):1264-1268.
[28]	段吉隆, 张晓娜, 常艳, 等. 移动医疗在呼吸系统疾病患者药物吸入管理中的应用进展[J]. 中华护理杂志, 2023, 58(20):2538-2542. DOI
	Duan JL, Zhang XN, Chang Y, et al. Research progress of mobile health in drug inhalation technology management of patients with respiratory diseases[J]. Chin J Nurs, 2023, 58(20):2538-2542. DOI
[29]	Anees Ur Rehman, Ahmad Hassali MA, Muhammad SA, et al. The economic burden of chronic obstructive pulmonary disease(COPD) in the USA,Europe,and Asia:results from a systematic review of the literature[J]. Expert Rev Pharmacoecon Out-comes Res, 2020, 20(6):661-672.
[30]	许扬, 张鹏俊, 杨汀, 等. 我国基层慢性阻塞性肺疾病防治现状研究[J]. 中国全科医学, 2016, 19(34):4153-4158.
	Xu Y, Zhang PJ, Yang T, et al. Current status of prevention and control of chronic obstructive pulmonary disease in primary care in China[J]. Chin Gen Pract, 2016, 19(34):4153-4158.
[31]	基层卫生健康司. 国家卫生健康委办公厅关于印发慢性阻塞性肺疾病患者健康服务规范(试行)的通知[EB/OL]. (2024-09-13)[2024-12-29]. http://www.nhc.gov.cn/jws/s7874/202409/f257fb0f305645e2b6be1bab5c07de84.shtml.
	Grassroots Health Department. Notice of the General Office of the National Health Commission on issuing the health service standards for patients with chronic obstructive pulmonary disease(trial)[EB/OL]. (2024-09-13)[2024-12-29]. http://www.nhc.gov.cn/jws/s7874/202409/f257fb0f305645e2b6be1bab5c07de84.shtml.
[32]	Lan XY, Lu XY, Yi BL, et al. Factors associated with self-management behaviors of patients with chronic obstructive pulmonary disease[J]. Jpn J Nurs Sci, 2022, 19(1):e12450.

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