以质量求发展,以服务铸品牌

护理学报 ›› 2020, Vol. 27 ›› Issue (21): 40-45.doi: 10.16460/j.issn1008-9969.2020.21.040

• 循证护理 • 上一篇    下一篇

终末期病人配偶照顾者体验质性研究的Meta整合

王蒙蒙1, 宋静雨1, 叶乃宽2, 徐天梦1, 岳鹏1   

  1. 1.首都医科大学 护理学院,北京 100069;
    2.山东大学临床医学院,山东 济南 250012
  • 收稿日期:2020-05-25 出版日期:2020-11-10 发布日期:2020-12-15
  • 通讯作者: 岳鹏(1980-),女,北京人,博士,副教授,学系主任。E-mail:pkuyuepeng@ccmu.edu.cn
  • 作者简介:王蒙蒙(1993-),女,河南商丘人,本科学历,硕士研究生在读。
  • 基金资助:
    教育部人文社科项目(19YJC840059); 广州泰和医学人文研究教育基金(23000-3050070)

Qualitative Research on Experience of Spouse of End-of-life Patients: A Meta-synthesis

WANG Meng-meng1, SONG Jing-yu1, YE Nai-kuan2, XU Tian-meng1, YUE Peng1   

  1. 1. School of Nursing, Capital Medical University, Beijing 100069, China;
    2. Clinical Medical College, Shandong University,Jinan 250012, China
  • Received:2020-05-25 Online:2020-11-10 Published:2020-12-15

摘要: 目的 系统总结终末期病人配偶体验的质性研究,为构建基于配偶体验的支持方案提供依据。方法 计算机检索PubMed、The Cochrane Library、Web of Science、MEDLINE、EMbase、中国知网、CBM、万方数据库、VIP数据库,搜集有关终末期患者配偶照顾者体验的质性研究,检索时限为建库至2020年1月。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准(2017版)评价文献质量,使用Nvivo 11软件通过汇集性整合的方法进行结果整合。结果 共纳入12项研究,提炼出14个明确的研究结果,将相似的研究结果归纳形成8个新类别,得出2个整合结果。整合结果1:配偶照顾病人时的资源、动机、行为、感受和困境;整合结果2:病人死亡临近对夫妻关系、配偶的态度和感受的影响。结论 配偶在照顾终末期病人时有丰富的体验,专业人员应关注配偶的积极体验、夫妻关系变化和面对死亡时的态度;促进配偶与相同处境的人共享经验、增加与病人的沟通。

关键词: 终末期, 配偶, 体验, 质性研究, 系统综述

Abstract: Objective To systematically review the qualitative research on experience of end-of-life (EOL) of patients' spouse, to provide evidence for constructing support programs based on spouses' experience. Methods We searched databases in both English and Chinese, including PubMed, The Cochrane Library, Web of Science, MEDLINE, EMbase, CNKI, CMB, Wanfang Data and VIP from the inception to January 2020, to collect qualitative studies on the experience of the spouse of EOL patients. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies (2017 edition) in Australia. The results were integrated by using Nvivo 11 software. Results A total of 12 studies were included, and 14 complete findings were grouped according to their similarities to form 8 categories., which resulted in 2 synthesized findings: (1) resources, motivations, behaviors, feelings, and dilemmas of spouses in caring for patients;(2) effects of the proximity of patients' death on marital relationships, spouses' attitudes, and feelings. Conclusion Spouses have rich experiences in caring for EOL patients. Professionals should pay attention to the positive experiences of the spouses, changes in marital relationship and their attitudes towards death; encourage spouses to share experiences among spouses in the same situation; and promote their communication with patients.

Key words: terminal illness, spouse, experience, qualitative research, systematic review

中图分类号: 

  • R473
[1] Su H, Cao J,Zhou Y,et al.The Mediating Effect of Coping Style on Personality and Mental Health Among Elderly Chinese Empty-nester: A Cross-Sectional Study[J]. Arch Gerontol Geriatr, 2018(75):197-201.DOI:10.1016/j.archger.2018.01.004.
[2] Harding R,Gao W,Jackson D,et al.Comparative Analysis of Informal Caregiver Burden in Advanced Cancer, Dementia, and Acquired Brain Injury[J]. J Pain Symptom Manage, 2015, 50(4):445-452. DOI:10.1016/j.jpainsymman.2015.04.005.
[3] 杜鹏,王红丽. 老年人日常照料角色介入的差序格局研究[J].人口与发展,2014,20(5):85-92.DOI:10.3969/j.issn.1674-1668.2014.05.011.
[4] 周天. 基于logit模型的恶性肿瘤终末期临终关怀决策影响因子分析[D]. 北京:北京中医药大学,2013.
[5] 郭丽娜,郝勇. 个体健康、家庭照护和社会供给:谁更影响老人的居家养老服务需求[J]. 西北人口, 2019, 40(5):36-49.
[6] Buckley T,Spinaze M,Bartrop R,et al.The Nature of Death, Coping Response and Intensity of Bereavement Following Death in the Critical Care Environment[J]. Aust Crit Care, 2015, 28(2):64-70.DOI:10.1016/j.aucc.2015.02.003.
[7] 陈李妍. 居家临终癌症患者家庭照顾者照顾体验研究[D]. 广州:南方医科大学,2019.
[8] 焦开山. 中国老人丧偶与其死亡风险的关系分析——配偶照顾的作用[J]. 人口研究, 2010(3):64-76.
[9] Chow AY,Chan CL,Ho SM,et al.Qualitative Study of Chinese Widows in Hong Kong: Insights for Psycho-Social Care in Hospice Settings[J]. Palliat Med, 2006, 20(5):513-520.DOI:10.1191/0269216306pm1168oa.
[10] Mossin H, Landmark BT.Being Present in Hospital When the Patient Is Dying-A Grounded Theory Study of Spouses Experiences[J]. Eur J Oncol Nurs, 2010, 15(5):382-389.DOI:10.1016/j.ejon.2010.11.005.
[11] 金丽萍,张绮. 家庭式病房晚期癌症患者配偶照护感受的质性研究[J]. 解放军护理杂志, 2016, 33(20):20-23.DOI:10.3969/j.issn.1008-9993.2016.20.005.
[12] Chung BPM, Leung D, Leung SM, et al.Beyond Death and Dying: How Chinese Spouses Navigate the Final Days with Their Loved Ones Suffering from Terminal Cancer[J]. Support Care Cancer,2018,26(1):261-267.DOI:10.1007/s00520-017-3844-z.
[13] Gardner DS.Cancer in a Dyadic Context: Older Couples' Negotiation of Ambiguity and Search for Meaning at the End of Life[J]. J Soc Work End Life Palliat Care, 2008, 4(2):135-159.DOI:10.1080/15524250802353959.
[14] Weibull A, Olesen F, Neergaard MA.Caregivers' Active Role in Palliative Home Care-To Encourage or to Dissuade? A Qualitative Descriptive Study[J].BMC Palliat Care, 2008,16(7):15.DOI:10.1186/1472-684X-7-15.
[15] Turner M, King C, Milligan C, et al.Caring for a Dying Spouse at the End of Life:‘It's One of the Things You Volunteer for When You Get Married': A Qualitative Study of the Oldest Carers' Experiences[J]. Age Ageing, 2016, 45(3):421-426.DOI:10.1093/ageing/afw047.
[16] Fisker T,Strandmark M.Experiences of Surviving Spouse of Terminally Ill Spouse: A Phenomenological Study of an Altruistic Perspective[J]. Scand J Caring Sci, 2007,21(2): 274-281.DOI:10.1111/j.1471-6712.2007.00466.x.
[17] Lin H, Lin W, Lee T, et al.Living Experiences of Male Spouses of Patients with Metastatic Cancer in Taiwan[J]. Asian Pac J Cancer Prev,2013,14(1):255-259.DOI:10.7314/apjcp.2013.14.1.255.
[18] Judd R, Guy H, Howard RA.Caring for a Dying Partner: The Male Experience[J]. J Palliat Care, 2018,34(1):5-11.DOI:10.1177/0825859718774679.
[19] Egerod I, Kaldan G,Shaker SB,et al.Spousal Bereavement After Fibrotic Interstitial Lung Disease: A Qualitative Study[J]. Respir Med,2019,146(1):129-136.DOI:10.1016/j.rmed.2018.12.008.
[20] Digiacomo MBMH, Lewis JRBM,Nolan MTRM,et al.Transitioning from Caregiving to Widowhood[J]. J Pain Symptom Manage, 2013,46(6):817-825.DOI:10.1016/j.jpainsymman.2013.01.005.
[21] 张丹妮,朱慧,谢传艺,等. 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.DOI:10.16460/j.issn1008-9969.2020.04.032.
[22] Hui D,Nooruddin Z,Didwaniya N,et al.Concepts and Definitions for “Actively Dying,” “End of Life,” “Terminally Ill,” “Terminal Care,” and “Transition of Care”: A Systematic Review[J]. J Pain Symptom Manage,2014,47(1): 77-89.DOI:10.1016/j.jpainsymman.2013.02.021.
[23] Anon.JBI Critical Appraisal Checklist for Qualitative Research2017[EB/OL].[2020-02-08].https://joannabriggs.org/sites/default/files/2019-05/JBI_Critical_Appraisal-Checklist_for_Qualitative_Research2017_0.pdf.
[24] 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.
[25] 王剑利. 病友互助的类家族主义原则——对糖尿病互助群体的组织人类学考察[J]. 思想战线,2019,45(1):37-47.DOI:10.3969/j.issn.1001-778X.2019.01.005.
[26] 姜永志,张海钟. 中国人自我的本土化心理研究——“忍”的和谐思想[J]. 延边大学学报(社会科学版),2010,43(2): 113-116.DOI:10.3969/j.issn.1009-3311.2010.02.020.
[27] Cloyes KG,Hart SE,Jones AK,et al.Where Are the Family Caregivers? Finding Family Caregiver-Related Content in Foundational Nursing Documents[J]. J Prof Nurs,2020,36(1):76-84.DOI:10.1016/j.profnurs.2019.06.004.
[28] 陆宇晗. 我国安宁疗护的现状及发展方向[J]. 中华护理杂志,2017, 52(6):659-664.DOI:10.3761/j.issn.0254-1769.2017.06.004.
[29] Grindrod A, Rumbold B.Healthy End of Life Project (HELP): A Progress Report on Implementing Community Guidance on Public Health Palliative Care Initiatives in Australia[J]. Ann Palliat Med, 2018, 7(Suppl 2):S73-S83.DOI:10.21037/apm.2018.04.01.
[30] Kayser K,Acquati C,Reese JB,et al.A Systematic Review of Dyadic Studies Examining Relationship Quality in Couples Facing Colorectal Cancer Together[J].Psychooncology,2018,27(1):13-21.DOI:10.1002/pon.4339.
[31] Mowll J,Lobb EA,Lane L,et al.A Preliminary Study to Develop an Intervention to Facilitate Communication Between Couples in Advanced Cancer[J].Palliat Support Care,2015,13(5):1381-1390.DOI:10.1017/S1478951514001333.
[32] Lewis FM, Cochrane BB, Fletcher KA, et al.Helping Her Heal: A Pilot Study of an Educational Counseling Intervention for Spouses of Women With Breast Cancer[J]. Psychooncology,2008,17(2):131-137.DOI:10.1002/pon.1203.
[33] 李智,刘均娥,陈双琴,等. 乳腺癌患者配偶夫妻沟通干预方案的修订与实施[J]. 中国护理管理,2016,16(2):202-206. DOI:10.3969/j.issn.1672-1756.2016.02.014.
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