ICU病人和照顾者对谵妄相关性痛苦体验质性研究的Meta整合  

Qualitative research on delirium related pain experiences of ICU patients and caregivers:a Meta-synthesis

作　　者：黄聪 谷梅[1] HUANG Cong;GU Mei(Hunan Cancer Hospital,Hunan 410013 China)

机构地区：[1]湖南省肿瘤医院,湖南410013

出　　处：《循证护理》2024年第23期4181-4186,共6页Chinese Evidence-Based Nursing

基　　金：湖南省卫生健康委科研课题一般项目,编号:202214055627;湖南省自然科学基金医卫联合项目,编号:2024JJ9275。

摘　　要：目的:系统整合重症监护室(ICU)病人和照顾者在病人住院期的真实体验,为制定有针对性、多元化的谵妄相关性痛苦管理干预措施提供证据参考。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Web of Science、CINAHL、EBSCO、EMbase、PsycINFO、the Cochrane Library、美国临床试验数据库中关于病人和照顾者参与ICU谵妄病人体验的质性研究,检索时限为建库至2024年2月。采用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评价文献质量,采用Meta整合方法对结果进行整合。结果:共纳入9篇文献,包括3项现象学研究、1项扎根理论研究、5项描述性质性研究,提炼出8个类别,最终汇总成4个整合结果:ICU谵妄病人存在负性情感体验;ICU谵妄病人经历了身体和精神方面的痛苦;照顾者感到同情、焦虑以及对未来的担忧;谵妄相关性痛苦的中介因素。结论:现有证据表明,病人在ICU谵妄期间的体验包括明显的负性情绪和其他形式的痛苦,照顾者应高度重视病人需要的心理支持。未来的研究应利用这些建议进一步探索和解决危重症护理中与谵妄多方面的相关性痛苦。Objective:To conduct a Meta-synthesis of real experience of patients and their families in delirium related pain in intensive care unit(ICU),in order to provide information for the development of targeted and diversified delirium management interventions.Methods:A qualitative study on the home care needs of patients with enterostomy was conducted by computer search on CNKI,WanFang Database,CBM,PubMed,Web of Science,CINAHL,EBSCO,EMbase,PsycINFO,the Cochrane Library and Clinicaltrials.gov.The retrieval time was from the inception to February 2024.The quality of literature was evaluated using the quality evaluation criteria of evidence-based healthcare centers at the Joanna Briggs Institute in Australia and integrated using the Meta-synthesis method.Results:A total of 9 articles were included,including 3 phenomenological studies,1 grounded theory study,and 5 descriptive studies.8 categories were extracted and finally summarized into 4 integrated results:ICU delirium patients had negative emotional experiences,ICU delirium patients experience physical and mental pain,caregivers feel sympathy,anxiety,and worries about the future,mediating factors of delirium related pain.Conclusion:Current evidence shows that the experience of patients and their families during delirium in the ICU includes significant negative emotions and other forms of pain,and high attention should be paid to the psychological support needed by their families.Future research should utilize these recommendations to further explore and address the multifaceted pain associated with delirium in critical care.

关 键 词：谵妄 重症监护室 照顾者 病人 质性研究 Meta整合 循证护理 

分 类 号：R473[医药卫生—护理学]