Self-care decision-making experience of heart failure patients:a meta-synthesis of qualitative research
刘晓君 1杜中艳 1王立娜 1杨丽娟2
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作者信息
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
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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.
Abstract
Objective To 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.Methods Qualitative 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.Results A 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.Conclusions The 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.
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