Abstract:

Objective To systematically evaluate and synthesize the experience and coping process of bowel symptoms in patients after sphincter-preserving surgery for rectal cancer，and to provide the evidence for the subsequent development of bowel symptom management strategies. Methods A comprehensive search was conducted across the Pubmed，Cochrane Library，CINAHL，Embase，Web of Science，CNKI，Wanfang Database，VIP Database and CBM Database for qualitative studies on the experience of bowel symptoms in post-sphincter-preserving surgery patients with rectal cancer. The search period was from database inception to October 2024. The quality of the included literature was assessed according to the Australian Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research，and the results were synthesized through the aggregative integration method. Results 14 studies were included，yielding 52 research findings，which were grouped into 10 subcategories and further synthesized into 4 results：the physical and psychological experiences of patients with bowel symptoms；the impact of bowel symptoms on patients’ daily lives；coping styles for bowel symptoms in patients；facilitators of patients bowel symptom coping. Conclusion Bowel symptoms have significant negative impacts on the lives of patients following sphincter-preserving surgery for rectal cancer，and healthcare professionals should address these patients’ needs by developing effective symptom management strategies and supporting patients in enhancing self-management abilities to improve quality of life.

Key words: Rectal Cancer, Sphincter Preserving Surgery, Bowel Symptoms, Qualitative Research, Meta-synthesis, Evidence-Based Nursing

摘要：

目的 系统评价并整合直肠癌保肛术后患者肠道症状的体验及应对过程，为后续制订肠道症状管理策略提供依据。方法 计算机检索PubMed、Cochrane Library、CINAHL、Embase、Web of Science、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有关直肠癌保肛术后患者肠道症状体验的质性研究，检索时限为建库至2024年10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质量评价标准对研究进行方法学质量评价，并应用汇集性整合方法对文献进行整合。结果 最终纳入14篇文献，提炼出52个研究结果，归纳为10个新类别，进一步整合为4个结果，即肠道症状及其对患者身心的影响、肠道症状对患者生活的影响、患者应对肠道症状的策略、患者应对肠道症状的促进因素。结论 直肠癌保肛术后患者的肠道症状对其生活产生了诸多影响，建议医护人员关注此类患者的症状管理需求，为其制订有效的管理策略，并帮助患者提升自我管理能力，以改善其生活质量。

关键词: 直肠癌, 保肛术, 肠道症状, 质性研究, Meta整合, 循证护理学