以质量求发展，以服务铸品牌

护理学报 ›› 2020, Vol. 27 ›› Issue (18): 42-49.doi: 10.16460/j.issn1008-9969.2020.18.042

• 循证护理 • 上一篇    下一篇

急性冠状动脉综合征患者介入术后真实体验质性研究的系统评价

李亚楠1, 刘姝1, 尤奥林1, 刘萍1, 栾晓嵘1,2   

  1. 1.山东大学 护理学院,山东 济南 250000;
    2.山东大学齐鲁医院,山东 济南 250000
  • 收稿日期:2020-02-11 出版日期:2020-09-25 发布日期:2020-10-16
  • 通讯作者: 栾晓嵘（1969-）,女,山东济南人,博士学历,教授,博士研究生导师。E-mail:luanxrong@163.com
  • 作者简介:李亚楠（1995-）,女,山东青岛人,硕士,护士。
  • 基金资助:
    山东省社会科学规划研究项目（P20190512084734605）

Experience of Patients with Acute Coronary Syndrome after Interventional Therapy: A Systematic Review of Qualitative Studies

LI Ya-nan1, LIU Shu1, YOU Ao-lin1, LIU Ping1, LUAN Xiao-rong1,2   

  1. 1. School of Nursing, Shandong University, Jinan 250000, China;
    2. Qilu Hospital of Shandong University, Jinan 250000, China
  • Received:2020-02-11 Online:2020-09-25 Published:2020-10-16

PDF (PC)

393

赞

摘要： 目的 系统评价急性冠状动脉综合征患者介入术后真实体验的质性研究,为医护人员制定干预措施、促进患者整体健康提供依据。方法 检索The Cochrane Library、PubMed、Web of Science、Embase、Science Direct及CNKI、CBM、VIP、万方数据库从建库至2019年5月16日的质性研究。通过JBI循证卫生保健中心质性研究质量评价标准评价纳入研究的质量,采用Meta整合方法整合结果。结果 共纳入9项研究,提炼39个完整结果,归纳出8个类别,形成4个整合结果：经皮冠状动脉介入术后疾病感受的多样性;患者疾病信息的缺乏;康复期的变化;对社会支持的渴望。结论 急性冠状动脉综合征患者术后在心理、生理及社会功能等方面均受影响,生活方式明显改变,渴望信息及情感支持,医护人员应针对其不良情绪和疾病管理给予指导,帮助其建立积极应对方式,协助家属完善患者社会支持系统,加快患者康复进程。

关键词: 急性冠状动脉综合征, 冠状动脉介入, 质性研究, 系统评价

Abstract: Objective To systematically evaluate the real experience of patients with acute coronary syndrome (ACS) after interventional therapy, to provide basis for medical staff to develop intervention measures and promote the overall health of patients. Methods We collected literatures on the experience of ACS patients after interventional therapy in The Cochrane Library, PubMed, Embase, Science Direct, Web of Science, CBM, CNKI, WANFANG and VIP from the inception to May 16th, 2019. The JBI critical appraisal tool for qualitative studies in Australia was used to evaluate the quality of studies. Meta aggregative approach was used to integrate the results. Results A total of 9 studies were included, in which there were 39 complete research results, 8 categories, and 4 integrated results as followed: psychological feelings after PCI; inadequate information; changes during the rehabilitation and the desire for social support. Conclusion Psychological, physiological and social functions of ACS patients after interventional therapy were affected and obvious changes in the way of life were found so they are eager for information and social support. Medical staff should provide personalized guidance for adverse emotions and disease management, help them establish a positive coping mode, improve the social support system of patients, thus to promote the rehabilitation of the patients.

Key words: acute coronary syndrome, percutaneous coronary intervention, qualitative research, systematic review

中图分类号: 

  • R473.56
[1] Abajobir AA, Abate KH,Abbafati C,et al.Global, Regional, and National Disability-adjusted Life-years (DALYs) for 333 Diseases and Injuries and Healthy Life Expectancy (HALE) for 195 Countries and Territories, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016[J]. Lancet,2017,390(10100):1260-1344. DOI:10.1016/S0140-6736(17)32130-X.
[2] 马丽媛,吴亚哲,陈伟伟. 《中国心血管病报告2018》要点介绍[J]. 中华高血压杂志,2019,27(8):712-716.DOI:10.16439/j.cnki.1673-7245.2019.08.006.
[3] Yamaguchi T, Nakamura M, Mitsuo K, et al.Percutaneous Coronary Intervention in Acute Coronary Syndrome[J]. Internal Medicine,2000,39(4):337-338. DOI: https://doi.org/10.2169/internalmedicine.39.337.
[4] 冷敏,荣山伟,曹国荣,等. 居家自助式心脏康复方案在急性冠脉综合征行经皮冠状动脉介入术术后出院患者中的应用[J]. 解放军护理杂志,2019,36(1):56-59. DOI:10.3969/j.issn.1008-9993.2019.01.00.
[5] Mosleh SM, Eshah NF, Almalik MM.Perceived Learning Needs According to Patients Who Have Undergone Major Coronary Interventions and Their Nurses[J].J Clin Nurs, 2017, 26(3-4):418-426. DOI:10.1111/jocn.13417.
[6] 杜若飞,陈长英. 心肌梗死患者重返工作岗位后心理体验的研究[J]. 中华护理杂志, 2018,53(8):920-925. DOI:10.3761/j.issn.0254-1769.2018.08.004.
[7] Mehrpoya A, Jalali R, Jalali A,et al.Patient Experiences of Living with Coronary Stent[J].J Vasc Nurs,2018,36(4):181-185. DOI:10.1016/j.jvn.2018.07.002.
[8] Pettersen TR,Fridlund B,Bendz B,et al.Challenges Adhering to a Medication Rregimen Following First-time Percutaneous Coronary Intervention: A Patient Perspective[J]. Int J Nurs Stud,2018,88(12):16-24.DOI:10.1016/j.ijnurstu.2018.07.013.
[9] Iles-Smith H,Deaton C,Campbell M,et al.The Experiences of Myocardial Infarction Patients Readmitted within Six Months of Primary Percutaneous Coronary Intervention[J]. J Clin Nurs,2017,26(21-22):3511-3518.DOI:10.1111/jocn.13715.
[10] 赵瑞,拜争刚,黄崇斐,等. 质性研究系统评价在循证指南制定中的应用价值[J]. 中国循证医学杂志,2016,16(7): 855-859. DOI:10.7507/1672-2531.20160131.
[11] 胡雁. 循证护理学[M]. 北京:人民卫生出版社,2012:130-141.
[12] Lockwood C,Munn Z,Porritt K.Qualitative Research Synthesis: Methodological Guidance for Systematic Reviewers Utilizing Meta-aggregation[J]. Int J Evid Based Healthc, 2015,13(3):179-187.DOI:10.1097/XEB.0000000000000062.
[13] 郭春棉,唐冲,杨秦,等. 急性心肌梗死植入支架患者的质性研究[J]. 中国保健营养, 2012,22(12):1813-1813. DOI: 10.3969/j.issn.1004-7484(x).2012.07.067.
[14] 冯萍,王海芳,陆敏霞,等. 急性心肌梗死支架植入患者术后早期体验的研究[J]. 护理学杂志,2014, 29(9):20-22. DOI:10.3870/hlxzz.2014.09.020.
[15] 赵杰刚,焦丹丹,李转珍,等. 急性心肌梗死患者住院期间心理体验的质性研究[J]. 中华心血管病杂志,2015,43(7): 605-608.DOI:10.3760/cma.j.issn.025 3-3758.2015.07.008.
[16] Astin F,Closs SJ,Mclenachan J,et al.The Information Needs of Patients Treated with Primary Angioplasty for Heart Attack: An Exploratory Study[J]. Patient Educ Couns,2008,73(2):325-332. DOI:10.1016/j.pec.2008.06.013.
[17] Odell A,Grip L,Hallberg LR.Restenosis after Percutaneous Coronary Intervention (PCI): Experiences from the Patients’ Perspective[J]. Eur J Cardiovasc Nurs,2006,5(2):150-157.DOI:10.1016/j.ejcnurse.2005.10.004.
[18] Radcliffe EL,Harding G,Rothman MT,et al.‘It Got Right to the Spot’the Patient Experience of Primary Angioplasty: A Qualitative Study[J]. Eur J Cardiovasc Nurs, 2009,8(3): 216-222. DOI:10.1016/j.ejcnurse.2009.02.001.
[19] O’Keefe-Mccarthy S, Mcgillion M, Clarke SP,et al. Pain and Anxiety in Rural Acute Coronary Syndrome Patients Awaiting Diagnostic Cardiac Catheterization[J]. J Cardiovasc Nurs,2015,30(6):546-557.DOI:10.1097/JCN.0000000000000203.
[20] Deane KA,Degner LF. Information Needs, Uncertainty, and Anxiety in Women Who Had a Breast Biopsy with Benign Outcome[J]. Cancer Nurs, 1998, 21(2):117-126.DOI:10.1097/00002 820-199804000-00005.
[21] Mishel MH.Uncertainty in Illness[J]. J Nurs Scholarsh,1988, 20(4):225-232.DOI:org/10.1111/j.1547-5069.1988.tb00082.x.
[22] 芦艳,蒋维连,冯爱素. 乳腺癌术后治疗期间疾病不确定感体验与应对方式的质性研究[J]. 护理与康复,2015,14(5):406-409. DOI:10.3969/j.issn.1671-9875.2015.05.002.
[23] 马蕙,杨富国,卢晓虹,等. 经皮冠状动脉介入治疗患者自我管理行为现状及影响因素分析[J]. 护理学报,2018,25(20):1-4. DOI:10.16460/j.issn1008-9969.2018.20.001.
[24] Francesco F,Elisabetta A.The Bare Minimum of Information at Discharge after Acute Coronary Syndrome. Part 2: The Quality Improvement Project[J]. Monaldi Arch Chest Dis,2012,78(3):138-147. DOI:10.4081/monaldi.2012.119.
[25] 蔡立慧,黄婉纯,麦婉萍. 同步施教对PCI术后患者的生活质量影响[J]. 中国现代药物应用,2016,10(15):251-252. DOI:10.14164/j.cnki.cn11-5581/r.2016.15.184.
[26] 刘佳妮,徐峰. 心脏康复运动指导对ACS患者介入术后生活质量的影响[J]. 心血管康复医学杂志,2017,26(6): 581-586. DOI:10.3969/j.issn.1008-0074.2017.06.01.
[27] Kähkönen O,Kankkunen P,Miettinen H,et al.Perceived Social Support Following Percutaneous Coronary Intervention is a Crucial Factor in Patients with Coronary Heart Disease[J]. J Clin Nurs,2016,26(9-10):1264-1280. DOI:10.1111/jocn.13527.
[28] 雷莎,丁荣晶,王历,等. 急性冠状动脉综合征患者社会支持现况及影响因素分析[J]. 中华心血管病杂志,2017,45(5):399-403.DOI:10.3760/cma.j.issn.0253-3758.2017.05.007.
[29] Jonge PD, Zuidersma M, Bültmann U.The Presence of a Depressive Episode Predicts Lower Return to Work Rate after Myocardial Infarction[J]. Gen Hosp Psychiatry,2014,36(4):363-367.DOI:10.1016/j.genhosppsych.2014.03.006.
[30] Olson K.A New Way of Thinking About Fatigue: A Reconceptualization[J]. Oncol Nurs Forum,2007, 34(1):93-99. DOI:10.1188/07.ONF.93-99.
[31] Alsen P,Brink E,Persson LO.Living with Incomprehensible Fatigue after Recent Myocardial Infarction[J]. J Adv Nurs,2008,64(5):459-468.DOI:10.1111/j.1365-2648.2008. 0477
x.
[32] 罗世香,刘均娥,肖树芹. 乳腺癌康复者重返工作岗位相关研究现状[J].中国护理管理,2016,16(2):199-202. DOI:10.3969/j.issn.1672-1756.2016.02.013.
[1] 刘丽萍, 吴艳妮, 从维莲, 胡明钰, 李晓霞, 周春兰. 癌症患者化疗期自我护理体验质性研究的系统评价[J]. 护理学报, 2020, 27(7): 1-6.
[2] 史冬梅, 田金萍, 许艳玲, 蒋宏粉, 陈韦, 王连生, 贾恩志, 陈磊磊. STEPTY P型压迫止血贴应用于经皮桡动脉冠状动脉介入术患者效果研究[J]. 护理学报, 2020, 27(7): 61-64.
[3] 尹霄朦, 胡波, 王薇, 姜园园, 莘秀芳, 朱秀丽. 基于角色理论医学硕士研究生对导师角色期望的质性研究[J]. 护理学报, 2020, 27(5): 1-5.
[4] 张新, 崔菡斐, 董凤齐, 郑瑞双. 护理学硕士学历护士临床工作体验的Meta整合[J]. 护理学报, 2020, 27(4): 25-31.
[5] 张丹妮, 朱慧, 谢传艺, 陈肖敏. 乳腺癌患者配偶照顾体验质性研究的Meta整合[J]. 护理学报, 2020, 27(4): 32-36.
[6] 李文玉, 涂文怡, 郑静, 黄小芳, 刘庆华, 徐小群. 样本量对质性研究主题与现象诠释的影响研究[J]. 护理学报, 2020, 27(3): 62-65.
[7] 莫梦燕, 詹昱新, 王楚, 陆艳娥. 参与冠状病毒引发呼吸道传染病救治护士职业暴露体验质性研究的Meta整合[J]. 护理学报, 2020, 27(19): 35-40.
[8] 范海霞, 马梦迪, 郑海为, 卢晓红, 鞠陶然, 邵珂, 杨富国. 首次经皮冠状动脉介入治疗术后患者健康素养现状及影响因素分析[J]. 护理学报, 2020, 27(16): 35-39.
[9] 王静远, 魏丽丽, 王刚, 孙文娟, 李倩倩, 张艳, 潘月帅, 李环廷. 15例新型冠状病毒肺炎患者疾病经历体验的质性研究[J]. 护理学报, 2020, 27(14): 63-67.
[10] 史逸秋, 戴晓婧, 冯占春. 综合医院新型冠状病毒肺炎收治专区护士长工作体验的质性研究[J]. 护理学报, 2020, 27(13): 47-51.
[11] 田凡立, 李惠玲, 杜美兰, 蒋芳琴, 张新梅, 殷雪群. 新型冠状病毒肺炎下援鄂男护士情绪体验的质性研究[J]. 护理学报, 2020, 27(12): 46-49.
[12] 张爱琴, 陈俊杉, 余金甜. ICU患者谵妄非药物管理相关指南的系统评价[J]. 护理学报, 2020, 27(11): 26-32.
[13] 叶冬婷, 张沁莲, 景霜, 郭佳, 邢雁芬. 家属对ICU患者转出体验的Meta整合[J]. 护理学报, 2020, 27(11): 33-39.
[14] 周莹, 卢洪洲, 张林, 孙美艳. 门诊艾滋病男患者对个案管理体验的质性研究[J]. 护理学报, 2020, 27(10): 1-4.
[15] 黄莺莺, 曹卫平, 韦嘉洁, 李妍. 妊娠期高血压疾病患者患病体验的质性研究[J]. 护理学报, 2020, 27(10): 5-9.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 刘爽,谢丹,张晓启. 糖尿病性心肌梗死患者的临床特点及护理对策[J]. 护理学报, 2012, 19(8): 50 -51 .
[2] 刘慧,靳艳,郑婧,王亚霖. 经皮冠状动脉介入术后中青年患者健康促进生活方式现状及影响因素分析[J]. 护理学报, 2016, 23(5): 14 -18 .
[3] 李海燕,范凤燕. 建立微信平台实施护理质控的效果观察[J]. 护理学报, 2016, 23(6): 34 -37 .
[4] 李霞,张宇,林细吟,李琨,许雅君,刘金玲,林少芒. 110例下肢动脉疾病患者自我管理行为水平的调查研究[J]. 护理学报, 2016, 23(7): 47 -50 .
[5] 韦素雨,陆柳雪,黄彩妹,黄明宜,农永英,韦惠云,何美兴,黄梅雪,马春节,岑朝,苏建伟. 百色地区幽门螺杆菌感染患者认知与遵医依从性调查研究[J]. 护理学报, 2016, 23(10): 30 -33 .
[6] 林玉珍,廖瑞梅,刘美凤,谢丽芬,阮定萍,黄爱莲,黄国彩. 282例乳房缺失患者社交回避与苦恼得分特征分析[J]. 护理学报, 2016, 23(10): 57 -59 .
[7] 王啟瑶,莫霖,刘洋,王紫娟,石林. 护理专业学位研究生导师胜任力评价体系的系统评价与Meta整合[J]. 护理学报, 2016, 23(17): 1 -6 .
[8] 叶增杰,阮小丽,曾珍,谢琼,程梦慧,彭超华,卢咏梅,邱鸿钟. 中文版10条目心理韧性量表在护生群体中的信效度分析[J]. 护理学报, 2016, 23(21): 9 -13 .
[9] 王颖雯,张玉侠,沈国妹,顾莺. 综合性儿童医院专科护士岗位管理实践[J]. 护理学报, 2016, 23(21): 38 -41,42 .
[10] 尚雅彬,滕沙,林晓鸿,刘红霞,王璐,张静,吴丝丝,杜春燕. 271例肝移植术后患者生活质量的调查分析[J]. 护理学报, 2016, 23(23): 1 -5 .