心力衰竭患者自我护理决策体验质性研究的Meta整合  

Self-care decision-making experience of heart failure patients:a meta-synthesis of qualitative research

作　　者：刘晓君 杜中艳 王立娜 杨丽娟 Liu Xiaojun;Du Zhongyan;Wang Lina;Yang Lijuan(School of Nursing and Rehabilitation,Shandong University,Jinan 250012,China;Nursing Department,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东大学护理与康复学院,济南250012 [2]山东第一医科大学附属省立医院护理部,济南250021

出　　处：《中华现代护理杂志》2024年第34期4679-4687,共9页Chinese Journal of Modern Nursing

摘　　要：目的系统评价心力衰竭患者参与自我护理决策体验的质性研究,为提高患者参与自我护理的积极性和制订自我护理决策干预方案提供参考依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、Proquest、CINAHL、中国知网、万方数据、维普网、中国生物医学文献数据库中与心力衰竭患者参与自我护理决策体验相关的质性研究与包含质性研究的混合性研究,检索时限均为建库至2024年3月31日。采用汇集性整合方法对研究结果进行整合。结果共纳入14篇文献,提炼24个研究结果,归纳成8个新的类别,形成心力衰竭自我护理决策面临多重困境,存在多方面担忧;患者参与心力衰竭自我护理决策受到多方面影响;患者感知动力,坚定自我护理信念应对决策3个整合结果。结论心力衰竭患者的自我护理行为对于改善预后至关重要,未来医护人员应结合个人价值观和偏好制订个性化自我护理干预,指引患者正确执行自我护理;完善"医院-家庭-社区"支持系统,保持护理连续性,提高患者的自我护理能力。ObjectiveTo systematically evaluate the qualitative research on the experience of heart failure patients participating in self-care decision-making,so as to provide reference for improving patients'enthusiasm for participating in self-care and formulating self-care decision-making intervention programs.MethodsQualitative studies(including mixed studies of qualitative studies)on the self-care decision-making experience of heart failure patients were electronically retrieved in PubMed,Embase,Web of Science,Cochrane Library,Proquest,CINAHL,China National Knowledge Infrastructure,WanFang Data,VIP,and China Biomedical Database.The search period was from database establishment to March 31,2024.The aggregative synthesis was used to integrate research results.ResultsA total of 14 articles were included,24 research results were extracted,and summarized into 8 new categories,forming three integrated results,including multiple dilemmas and concerns in heart failure self-care decision-making,multiple influences on patient participation in heart failure self-care decision-making,and patients'perceived motivation to cope with decision making with firm beliefs about self-care.ConclusionsThe self-care of heart failure patients is crucial for improving outcome.Medical and nursing staff should develop personalized self-care interventions based on personal values and preferences,guide patients to perform self-care correctly,improve the hospital-home-community support system,maintain continuity of nursing,and enhance patients'self-care.

关 键 词：心力衰竭 自我护理 决策 自然决策理论 Meta整合 

分 类 号：R473.5[医药卫生—护理学]