The impact of environmental factors on stroke patients at home:a qualitive meta-synthesis

doi:10.3761/j.issn.0254-1769.2020.02.022

Abstract

Abstract:

Objective To systematically review and synthesize qualitative studies on the effects of environmental factors on functional activities and social participation of patients with stroke at home,in order to provide evidence for community health workers to improve home environment of stroke patients and to enhance their functional activities and social participation. Methods We searched databases including PubMed,Embase,Web of Science,PsycINFO,CINAHL,CBM and CNKI from inception to January 2019,to collect qualitative studies exploring environmental factors affecting stroke patients’ activities and participation. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. Meta-synthesis was used to integrate results. Results A total of 12 studies were included,and 34 findings were grouped according to their similarities to form 9 categories. Integration results 1:obstacles in living environment directly restricted patients’ activities and social participation;integration results 2:social support was crucial;integration results 3:the existing transportation services and health care services were difficult to meet patients’ needs. Conclusion Barrier-free environment plays an important role in the rehabilitation process of stroke patients at home. Government,community medical and health institutions and other relevant personnel should pay full attention to the impact of environmental factors on stroke patients at home,and help them establish a good social support network. Community health care services should be improved,and supportive organizations for stroke patients should be established to meet the needs of stroke patients at home.

Key words: Stroke, Environmental Factors, Participation, Qualitative Research, Systematic Review, Meta-synthesis

摘要：

目的系统评价和整合环境因素对居家脑卒中患者功能活动及社会参与影响的质性研究,为社区医护人员改善脑卒中患者居家环境,进而提高其活动及社会参与水平提供理论依据。方法计算机检索PubMed、Embase、Web of Science、PsycINFO、CINAHL、中国生物医学文献数据库和中国知网关于环境因素影响居家脑卒中患者活动及参与的质性研究,检索时限从建库至2019年1月。采用澳大利亚Joanna Briggs Institute（JBI）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,运用Meta整合方法对结果进行整合。结果共纳入12篇文献,提炼34个结果,归成9个类别,合成3个整合结果。整合结果1:居住环境障碍直接限制患者活动及社会参与;整合结果2:良好的社会支持至关重要;整合结果3:现有的交通、卫生保健服务难以满足患者需求。结论无障碍环境在居家脑卒中患者康复进程中起重要推动作用;政府、社区医疗卫生机构等相关人员应全面关注环境因素对居家脑卒中患者的影响,帮助其建立良好的社会支持网络;健全并落实社区卫生保健服务、成立脑卒中患者支持性组织以满足居家脑卒中患者需求。

关键词: 脑卒中, 环境因素, 参与, 质性研究, 系统评价, Meta整合

WANG Wenna, ZHANG Zhenxiang, LIN Beilei, MEI Yongxia, DING Chunge. The impact of environmental factors on stroke patients at home:a qualitive meta-synthesis[J]. Chinese Journal of Nursing, 2020, 55(2): 281-287.

王文娜, 张振香, 林蓓蕾, 梅永霞, 丁春戈. 环境因素对居家脑卒中患者影响质性研究的Meta整合[J]. 中华护理杂志, 2020, 55(2): 281-287.

Figures/Tables 2

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