护理学杂志2024,Vol.39Issue(23) :87-92.DOI:10.3870/j.issn.1001-4152.2024.23.087

重症患者代理决策者生命支持决策体验质性研究的Meta整合

Meta-synthesis of qualitative studies on experiences of surrogate decision-makers in making life support decisions for the critically ill

崔梦娇 黄萍 王芳 刘凡 刘才艳 陈敬灏 陈璐
护理学杂志2024,Vol.39Issue(23) :87-92.DOI:10.3870/j.issn.1001-4152.2024.23.087

重症患者代理决策者生命支持决策体验质性研究的Meta整合

Meta-synthesis of qualitative studies on experiences of surrogate decision-makers in making life support decisions for the critically ill

崔梦娇 1黄萍 2王芳 3刘凡 4刘才艳 5陈敬灏 5陈璐5
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作者信息

  • 1. 南京中医药大学护理学院(江苏南京,210008);南京大学医学院附属鼓楼医院急诊医学科
  • 2. 南京大学医学院附属鼓楼医院急诊医学科
  • 3. 南京大学医学院附属鼓楼医院神经外科
  • 4. 江苏大学护理学院
  • 5. 南京中医药大学护理学院(江苏南京,210008)
  • 折叠

摘要

目的 整合危重症患者代理决策者决策体验的质性研究,揭示代理决策者共性体验,为开展针对性护理干预提供参考.方法 系统检索国内外数据库有关危重症患者代理决策者生命支持治疗决策体验的质性研究,检索时限为建库至2023年11月.对纳人文献进行质量评价,应用汇集性整合方法对提取结果进行整合.结果 共纳入12篇文献,提炼42个主要结果,归纳为11个类别,最终形成4个整合结果:艰难的决策过程,复杂的情感体验,多样的决策需求,生命末期的综合考量.结论 危重症患者代理决策者面临多元决策挑战,建议医护人员增加对代理决策者的关注,制订综合支持策略,增强代理决策者在生命支持决策中的应对能力,减轻代理决策的情感压力.

Abstract

Objective To integrate the existing qualitative research on experiences of surrogate decision-makers(SDM)in making life support decisions for the critically ill,to explore their common experiences and to provide reference for targeted intervention.Me-thods A systematic search was conducted in databases including China National Knowledge Infrastructure(CNKI),WanFang Data-base,VIP Database,SinoMed,PubMed,Embase,Web of Science,PsycINFO,and CINAHL for studies regarding the expe-riences of SDM in making life support decisions for the critically ill,from database inception until November 2023.Quality of the included studies was evaluated,and the meta-integration method was used to explain and integrate the research findings.Results A total of 12 articles were included in the study,from which 42 results were extracted and summarized into 11 categories.These cate-gories were further synthesized into four integrated themes:the challenging decision-making process,complex emotional feelings,diverse decision-making needs,and end-of-life care considerations.Conclusion SDM of critically ill patients face multifaceted deci-sion-making challenges.It is recommended that healthcare providers increase attention to SDM,develop comprehensive support strategies,enhance their ability to cope with life support decisions,and ultimately alleviate their emotional stress.

关键词

危重症/代理决策者/替代决策/决策体验/决策冲突/质性研究/生命支持/机械通气

Key words

critical illness/surrogate decision-maker/surrogate decision/decision-making experience/decision-making con-flict/qualitative research/life support/mechanical ventilation

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出版年

2024
护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCDCSCD北大核心
影响因子:2.062
ISSN:1001-4152
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