护士进行预立医疗照护计划实践体验质性研究的Meta整合  

Nurses'experience and reality dilemma in advance care planning:a qualitative meta-synthesis

作　　者：张馨 姬艳博 张秋悦 马晓萌[2] 张学靓 孟宇辰 王光娅 许翠萍[1] Zhang Xin;Ji Yanbo;Zhang Qiuyue;Ma Xiaomeng;Zhang Xuejing;Meng Yuchen;Wang Guangya;Xu Cuiping(Department of Nursing,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Jinan 250014,China;School of Nursing and Rehabilitation,Shandong University,Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)护理部,济南250014 [2]山东大学护理与康复学院,济南250014

出　　处：《中国实用护理杂志》2023年第20期1594-1600,F0003,共8页Chinese Journal of Practical Nursing

基　　金：山东省自然科学基金面上项目(ZR2021MG041);中华护理学会2020年度立项科研课题项目(ZHKY202029);济南市临床医学科技创新计划(202019199);山东第一医科大学(山东省医学科学院)青年科学基金培育资助计划项目(202202-24)。

摘　　要：目的系统评价和整合护士进行预立医疗照护计划(ACP)实践体验及现实困境的质性研究,为后续临床护士更好地开展ACP提供参考依据。方法计算机检索PubMed、Web of Science、Embase、CochraneLibrary、CINAHL、中国知网、万方、维普、中国生物医学文献数据库等中英文数据库,收集关于护士预立医疗照护计划实践体验及现实困境相关的质性研究,检索时限为建库至2022年8月1日。采用澳大利亚循证卫生保健中心(JBI)质性研究质量评价标准(2016)进行文献质量评价,运用Meta整合方法对结果进行汇总分析。结果共纳入13项研究,提炼出39个研究结果,归纳为11个新类别,形成4个整合结果:护士对ACP实践活动的认知;护士进行ACP实践活动的情绪体验;阻碍ACP实践的护士个人因素;阻碍ACP实践的外部环境因素。结论ACP实践中应积极引导护士正向的认知和情绪体验,提升ACP实践的胜任力,同时联合政府部门支持、整合医院、社会等多方力量针对阻碍因素制订应对策略,以促进ACP的发展与实践。Objective To systematically evaluate and integrate the qualitative research of the practical experience and practical difficulties of advance care planning(ACP),so as to provide a reference for subsequent clinical nurses to better carry out ACP.Methods PubMed,Web of Science,Embase,Cochrane Library,CINAHL,CNKI,Wanfang,VIP,Chinese Biomedical Literature Database were collected the qualitative research on the practical experience and practical difficulties of nurses'advance care planing,and the search time was the database establishment until August 1,2022.Literature quality evaluation was conducted by the Joanna Briggs Institute(JBI)(2016),and the results were summarized using Meta integration method.Results A total of 13 studies were included,and 39 studies were summarized into 1l new categories,forming 4 integrated results:nurses'cognition of ACP practice,emotional experience of nurses'ACP practice,personal factors that hinder ACP practice,and external environmental factors that hinder ACP practice.Conclusions In ACP practice,nurses should be actively guided to have positive cognitive and emotional experience to improve their competence in ACP practice.At the same time,government departments should be united to support,integrate hospitals,society and other forces to formulate coping strategies against obstacles,so as to promote the development and practice of ACP.

关 键 词：护士 定性研究 预立医疗照护计划 体验 Meta整合 

分 类 号：R47[医药卫生—护理学]