基于Meta人种学的生命末期家庭照顾体验理论模型的研究  

Theoretical model of family caregivers′experience of caring for patients at the end-of-life stage:a Meta-ethnography study

作　　者：来小彬 梁燕 Lai Xiaobin;Liang Yan(School of Nursing,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学护理学院基础护理教研室,上海200032

出　　处：《护理学杂志》2023年第1期97-103,共7页Journal of Nursing Science

基　　金：上海市2022年度“科技创新行动计划”软科学项目(22692113400)。

摘　　要：目的系统整合中国家庭在患者生命末期的照顾体验,明确家庭照顾体验的核心元素,尝试构建诠释中国家庭照顾生命末期患者现象的理论模型。方法系统检索6个英文数据库和5个中文数据库中发表在2021年12月之前的描述中国家庭在患者生命末期的照顾体验的质性研究或混合型研究。采用Meta人种学方法对纳入的16篇文献进行整合。结果整合形成了8个核心元素,即爱与责任、临终意识、伴行、告别、五味杂陈、生活改变、个人成长和需求。其中7个核心元素的GRADE-CERQual整合质量评价的可信度为低至中度,1个核心元素的可信度为高度。论证整合显示,患者优逝是中国家庭照顾者临终照顾的最终目标。结论中国家庭对临终患者的照顾体验过程是动态的,对患者的爱和责任是中国家庭照顾者坚持的动力,家庭照顾者会因患者获得优逝而感到欣慰。Objective To systematically integrate the family caregivers′experiences of caring for patients at the end-of-life stage in China,identify the key components during their caregiving process,and try to develop a theoretical model for Chinese family caregivers of patients at the end-of-life stage.Methods Six English databases and five Chinese databases were systematically searched for qualitative or mixed studies describing Chinese families′experience of caring for patients at the end-of-life published before December 2021.Meta-ethnography was performed to synthesise the 16 included studies.Results Eight core components of family caregi-vers′experience were identified,including:love and responsibility,the awareness of dying,companionship and care,farewell,fluctuating emotions,life changes,personal growth,and needs.Among them,the credibility of GRADE-CERQual integration quality evaluation of seven core elements was low to moderate,and the credibility of one core element was high,which showed that the patient′s good death was the ultimate goal of Chinese family caregivers′end-of-life care.Conclusion The Chinese family′s experience of caring for dying patients is dynamic,and the love and responsibility for patients are the driving force for Chinese family caregivers to persist in care,and family caregivers will feel gratified that patients have a good death.

关 键 词：家庭照顾者 照顾体验 生命末期 家庭支持 临终照护 优逝 Meta人种学 

分 类 号：R473.2[医药卫生—护理学] R48[医药卫生—临床医学]