老年终末期肾病患者共享决策体验质性研究的Meta整合  

The shared decision-making experience of elderly patients with end-stage renal disease:a systematic review and meta synthesis of qualitative studies

作　　者：崔金锐 肖琦 柯键 鄢建军[1] 曾铁英 CUI Jinrui;XIAO Qi;KE Jian;YAN Jianjun;ZENG Tieying

机构地区：[1]华中科技大学同济医学院附属同济医院肾病内科,武汉市430030 [2]华中科技大学同济医学院附属同济医院护理部,武汉市430030

出　　处：《中华护理杂志》2022年第7期863-871,共9页Chinese Journal of Nursing

基　　金：2021年度同济医院科研基金(2021D05)。

摘　　要：目的系统评价老年终末期肾病患者的共享决策体验,为更好辅助患者决策提供参考依据。方法计算机检索PsycINFO、PubMed、Embase、CINAHL和中国知网、中国生物医学文献数据库、万方数据库,收集关于老年终末期肾病患者共享决策体验的质性研究,检索时限为建库至2021年6月。采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心质性研究质量评价标准评价纳入文献的质量,采用汇集性整合方法对结果进行整合。结果共纳入13篇文献,提炼出36个研究结果,将相似结果归纳为8个新的类别,并综合成3个整合结果:共享决策信息支持与沟通实践、患者决策困境与心理轨迹、风险收益竞争决策与影响因素。结论医护人员应重视老年终末期肾病患者的决策体验,优化信息支持,改善沟通实践,充分考虑患者目标、价值观和偏好,推进以患者为中心的共享决策。Objective To systematically review the shared decision-making experience of elderly patients with end-stage renal disease.Methods We searched databases including PsycINFO,PubMed,Embase,CINAHL and CNKI,CBM,WanFang Data from the inception to June 2021.The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia.The results were integrated by integrating methods.Results A total of 13 studies were included.36 complete findings were grouped into 8 categories according to their similarities.These categories resulted in 3 synthesized findings:sharing decision-making information support and communication practices,the patient’s decision-making dilemma and psychological trajectory,risk-return competition decision and influencing factors.Conclusion Medical staff should pay attention to the decision-making experience of elderly patients with end-stage renal disease,fully consider their goals,values,and preferences,in order to promote patient-centered shared decision-making.

关 键 词：终末期肾病 肾透析 共享决策 老年护理学 Meta整合 

分 类 号：R473.5[医药卫生—护理学]