ICU患者照顾者代理决策体验质性研究的Meta整合  

The decision making experience of surrogate decision makers for critically ill patients:a qualitative Meta-synthesis research

作　　者：程志强 张宝珍[2] 夏娇云 李夏欣 周钰珏 王小星 付焕旭 闫程坤 CHENG Zhiqiang;ZHANG Baozhen;XIA Jiaoyun;LI Xiaxin;ZHOU Yujue;WANG Xiaoxing;FU Huanxu;YAN Chengkun

机构地区：[1]南昌大学护理学院,南昌市330006 [2]南昌大学第一附属医院护理部 [3]南昌大学第一附属医院急诊科

出　　处：《中华护理杂志》2023年第16期2027-2033,共7页Chinese Journal of Nursing

基　　金：江西省卫生健康委科技计划项目(202310357);江西省教育厅科学技术研究项目(GJJ2200153)。

摘　　要：目的总结ICU患者照顾者进行代理决策的感受与体验,为护理人员制订干预方案,帮助照顾者作出最佳决策提供参考依据。方法系统检索PubMed、Web of Science、Embase、Cochrane Library、PsycINFO、CINAHL、中国生物医学文献服务系统、中国知网、万方数据库、维普数据库,检索关于ICU患者照顾者决策体验的文献,检索时限为建库至2023年3月1日。根据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(2020版)对纳入文献进行质量评价,采用汇集性整合方法对研究结果进行总结与归纳。结果共纳入10篇文献,提取40个主题,归纳为11个类别,合并为3个整合结果:决策时的复杂心理、做出决策判断的依据、影响决策的因素。结论护理人员应该及时关注ICU患者照顾者进行代理决策时的体验,并给予充分的心理支持,从而帮助患者选择最佳治疗方案,改善其救治成功率和生活质量。Objective To summarize the feelings and experiences of surrogate decision makers of patients in ICU,and to provide references for clinical healthcare professionals to develop intervention plans and assist surrogate decision-makers in making the best decisions.Methods PubMed,Web of Science,Embase,Cochrane Library,PsycINFO,CINAHL,China Biomedical Literature Service System,China National Knowledge Network,Wanfang database and VIP database were searched systematically.The studies on the qualitative research of caregiver decision making experience for critically ill patients were searched until March 1,2023.The 2020 edition of the Joanna Briggs Institute(JBI)Quality Evaluation criteria for Evidence-Based health care centers was used to evaluate the quality of the included literature,and the findings were summarized using a pooled integration approach.Results A total of 10 pieces of literature were included,and a total of 40 topics were extracted and summarized into 11 categories,which were combined into 3 integrated results:complex psychologic status in decision making,the basis for making decisions and judgments,numerous factors affecting decision making.Conclusion Medical staff should pay attention to the psychological feelings of surrogate decision makers when making decisions,and give adequate psychological support,help patients choose the best treatment plan,improve the success rate of treatment and quality of life.

关 键 词：危重症患者 代理决策者 质性研究 Meta整合 护理 

分 类 号：R473[医药卫生—护理学]