严重精神障碍患者自我管理体验的Meta整合  

Self-management experiences in patients with Severe Mental Illness:a Meta-synthesis

作　　者：邓艺帆 王建宁[2] 彭梦婷 洪杜 DENG Yifan;WANG Jianning;PENG Mengting;HONG Du(Nursing School of Nanchang University,Nanchang,330006,China)

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

出　　处：《中国护理管理》2024年第9期1364-1370,共7页Chinese Nursing Management

基　　金：江西省重点研发计划项目(20171BBG70022)。

摘　　要：目的:系统评价严重精神障碍患者日常生活中的自我管理经历与体验的质性研究,了解其自我管理过程中的阻碍与促进因素,以及未满足的需求,为医护人员制定干预措施,改善严重精神障碍患者的健康结局提供依据。方法:计算机检索国内外数据库中关于严重精神障碍患者自我管理体验的质性研究,检索时限为建库至2023年10月30日。结果:共纳入16篇文献,提炼57个研究结果,归纳成13个新的类别,形成4个整合结果:严重精神障碍患者面临沉重的症状负担,自我管理格外艰难;探索个体化的自我管理策略,主动寻求改变;自我管理离不开外界支持;患者在自我管理中的需求未得到充分满足。结论:患者在沉重的症状负担面前通常缺乏有效的应对策略,自我管理的阻力较大。医护人员在此过程中需要提供多方面的支持,包括对患者症状应对与自我管理技能的教育及培训、搭建同伴支持平台、促进医患共同决策等,以提升其自我管理能力,从而改善其健康结局。Objective:To systematically evaluate qualitative research on self-management experiences of patients with Severe Mental Illness(SMI),and to understand the obstacles and promoting factors in the process of self-management,as well as unmet needs.To provide a basis for health care workers to develop interventions to improve physical outcomes in SMI patients.Methods:Computer search of domestic and foreign databases established the database until October 30,2023.Results:A total of 16 literature were included,57 research results were extracted and summarized into 13 new categories,forming 4 integrated results:patients with SMI face heavy symptom burden,and self-management is difficult;explore individualized strategies and actively seek change;self-management is inseparable from external support;patients'needs are not fully met.Conclusion:Patients usually lack effective strategies in face of the symptoms.In this process,medical staff need to provide various supports,including education and training of coping skills,setting up a peer support platform,and promoting doctor-patient joint decision-making,so as to enhance their self-management ability and improve their health outcomes.

关 键 词：严重精神障碍 自我管理 质性研究 精神护理 Meta整合 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]