以质量求发展,以服务铸品牌

护理学报 ›› 2021, Vol. 28 ›› Issue (2): 31-36.doi: 10.16460/j.issn1008-9969.2021.02.031

• 循证护理 • 上一篇    下一篇

慢性心力衰竭患者自我管理体验质性研究的Meta整合

王惠1, 仝旭1, 李玲2   

  1. 1.浙江中医药大学 护理学院,浙江 杭州 310053;
    2.浙江树人大学树兰国际医学院 护理教研室,浙江 杭州 310015
  • 收稿日期:2020-09-18 出版日期:2021-01-25 发布日期:2021-03-12
  • 通讯作者: 李玲(1973-),女,浙江杭州人,博士,副教授,硕士研究生导师,内科教研室主任。E-mail:59788937@qq.com
  • 作者简介:王惠(1988-),女,山西晋城人,本科学历,硕士研究生在读,主管护师。
  • 基金资助:
    浙江省基础公益研究计划项目(LGF20G030006); 2019年全国医学专业学位研究生教育指导委员会研究课题

Self-management of Patients with Chronic Heart Failure: A Qualitative Meta-integration

WANG Hui1, TONG Xu1, LI Ling2   

  1. 1. School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China;
    2. Nursing Teaching and Research Office, Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China
  • Received:2020-09-18 Online:2021-01-25 Published:2021-03-12

摘要: 目的 系统总结慢性心力衰竭患者的自我管理体验,全面了解其自我管理行为,为制定自我管理措施提供依据。方法 检索The Cochrane Library、JBI、CINAHL、PubMed、Web of Science、Science Direct、EBSCO、中国生物医学文献数据库、中国知网、万方、维普数据库从建库至2019年11月10日收录的关于慢性心力衰竭患者自我管理体验的质性研究。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评价文献质量,采用Meta整合的方法进行整合。结果 共纳入19项研究,提炼出74个研究结果,归纳形成7个新类别,综合得到3个整合结果。整合结果1:发展疾病相关健康行为,包括感知症状、建立健康行为2个类别;整合结果2:寻求与领悟支持,包括希冀外界支持、渴求疾病管理知识2个类别;整合结果3:积极应对,包括积极应对疾病、适应角色变化、领悟生命意义3个类别。结论 慢性心力衰竭患者意识到自我管理的重要性,在不断总结经验、调整自身行为的过程中发展疾病管理技能,逐步适应患病后生活,积极地建构新的生命意义。

关键词: 慢性心力衰竭, 自我管理, 质性研究, Meta整合

Abstract: Objective To systematically review the self-management experience of patients with chronic heart failure(CHF),to comprehensively understand patients' self-management behaviors and provide reference for formulating self-management measures. Methods We searched databases including The Cochrane Library, JBI, CINAHL, PubMed, Web of Science, Science Direct, EBSCO, CBM, CNKI, Wanfang, and VIP to collect qualitative studies on management experience of CHF patients from the inception to 10 November,2019.The quality of the literature was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated using a collective integration method. Results A total of 19 studies were included;74 research results were extracted; 7 new categories were summarized, and 3 integrated results were obtained: symptom perception and development of healthy behavior to maintain a good physiological state; facing the disease and seeking social support through multiple channels; adapting to the role change and gaining comfort of the soul in the process of understanding the meaning of life. Conclusion CHF patients gradually realizes the importance of self-management and develop disease management skill in the process of experience summary and behavior adjustment. More encourage and social support are conducive to helping patients to rebuild their life goals, pursue the meaning of life, and ultimately improve the quality of life.

Key words: chronic heart failure, self-management, qualitative research, Meta-integration

中图分类号: 

  • R473.54
[1] Benjamin EJ, Muntner P, Alonso A, et al.Heart Disease and Stroke Statistics-2019 Update: A Report from the American Heart Association[J]. Circulation, 2019, 139(10):e56-e528. DOI:10.1161/CIR.0000000000000659.
[2] 王宙,周琳,刘洋,等.慢性心力衰竭的流行病学研究现状及其防治研究进展[J].中国循证心血管医学杂志,2019, 11(8):1022-1024. DOI:10.3969/j.issn.1674-4055.2019.08.36.
[3] Savarese G, Lund LH.Global Public Health Burden of Heart Failure[J]. Card Fail Rev,2017,3(1):7-11. DOI:10.15420/cfr.2016:25:2.
[4] 衣艳凤,袁越,宋红霞,等.心力衰竭患者症状群与生活质量的相关性研究[J]. 护理学报,2018,25(1):14-17. DOI:10.16460/j.issn1008-9969.2018.01.010.
[5] 曹小彤,徐翠荣,王静静.慢性心力衰竭患者生活质量影响因素的病例对照研究[J]. 护理学报,2017,24(23):5-8. DOI:10.16460/j.issn1008-9969.2017.23.005.
[6] Riegel B, Moser DK, Buck HG, et al.Self-care for the Prevention and Management of Cardiovascular Disease and Stroke:A Scientific Statement for Healthcare Professionals from the American Heart Association[J]. J Am Heart Assoc, 2017, 6(9). DOI:10.1161/JAHA.117.006997.
[7] Spaling MA, Currie K, Strachan PH, et al.Improving Support for Heart Failure Patients: A Systematic Review to Understand Patients' Perspectives on Self-care[J].J Adv Nurs,2015, 71(11):2478-2489. DOI:10.1097/JCN.0000000000000118.
[8] 胡雁. 循证护理学[M].北京:人民卫生出版社,2012:130-140.
[9] Li CC, Chang SR, Shun SC.The Self-care Coping Process in Patients with Chronic Heart Failure: A Qualitative Study[J]. J Clin Nurs,2019,28(3/4):509-519. DOI:10.1111/jocn.14640.[10] Nordfonn OK, Morken IM, Bru LE, et al. Patients' Experience with Heart Failure Treatment and Self-carea Qualitative Study Exploring the Burden of Treatment[J]. J Clin Nurs, 2019, 28(9/10):1782-1793. DOI10.1111/jocn.14799.
[11] Sterling MR,Silva AF,Robbins L, et al.Let's Talk Numbers: A Qualitative Study of Community-dwelling Us Adults to Understand the Role of Numeracy in the Management of Heart Failure[J]. BMJ Open, 2018, 8(9):e023073. DOI:10.1136/bmjopen-2018-023073.
[12] van der Wal MHL, Jaarsma T, Moser DK, et al. Qualitative Examination of Compliance in Heart Failure Patients in the Netherlands[J]. Heart Lung, 2010, 39(2):121-130. DOI:10.1016/j.hrtlng.2009.07.008.
[13] Heo S, Lennie TA, Moser DK, et al.Heart Failure Patients' Perceptions on Nutrition and Dietary Adherence[J]. Eur J Cardiovasc Nurs, 2009, 8(5):323-328. DOI:10.1016/j.ejcnurse.2009.05.005.
[14] Chew HSJ, Sim KLD, Cao X, et al.Motivation, Challenges and Self-regulation in Heart Failure Self-care: A Theory-driven Qualitative Study[J]. Int J Behav Med, 2019, 26(5): 474-485. DOI:10.1007/s12529-019-09798-z.
[15] Rong XS, Peng YQ, Yu HP, et al.Cultural Factors Influencing Dietary and Fluid Restriction Behaviour:Perceptions of Older Chinese Patients with Heart Failure[J].J Clin Nurs, 2017,26(5/6):717-726. DOI:10.1111/jocn.13515.
[16] Riegel B,Carlson B.Facilitators and Barriers to Heart Failure Self-care[J]. Patient Educ Couns, 2002, 46(4):287-295. DOI:10.1016/s0738-3991(01)00165-3.
[17] 郭海燕,金园园,朱艳,等.慢性心力衰竭患者自我监测需求的质性研究[J].中华现代护理杂志, 2018, 24(10):1155-1158. DOI:10.3760/cma.j.issn.1674-2907.2018.10.007.
[18] 俞海萍,彭幼清,徐文妹,等.慢性心力衰竭患者自我管理真实体验的质性研究[J].解放军护理杂志, 2017, 34(11): 22-25. DOI:10.3969/j.issn.1008-9993.2017.11.005.
[19] 何涛,张国华,方艳春,等.慢性心力衰竭病人体重管理行为预测因子的质性研究[J].全科护理, 2019, 17(15):1885-1887. DOI:10.12104/j.issn.1674-4748.2019.15.038.
[20] Wu JR, Moser DK, Lennie TA, et al.Factors Influencing Medication Adherence in Patients with Heart Failure[J]. Heart Lung, 2008, 37(1):8-16.
[21] Meraz R. Medication Nonadherence or Self-care? Understanding the Medication Decision-making Process and Experiences of Older Adults with Heart Failure[J]. J Cardiovasc Nurs, 2020,35(1)26-34. DOI:10.1097/JCN.0000000000000616.
[22] Woda A, Haglund K, Belknap RA, et al.Self-care Behaviors of African Americans Living with Heart Failure[J]. J Community Health Nurs, 2015, 32(4):173-186. DOI:1080/07370016.2015.1087237.
[23] Son YJ, Lee YM, Kim EY.How Do Patients Develop Self-care Behaviors To Live Well With Heart Failure: A Focus Group Interview Study[J]. Collegian, 2019, 26(4):448-456. DOI:10.1016/j.colegn.2018.12.004.
[24] Schumacher C, Hussey L, Hall V.Heart Failure Self-management and Normalizing Symptoms:An Exploration of Decision Making in the Community[J]. Heart Lung, 2018, 47(4):297-303. DOI:10.1016/j.hrtlng.2018.03.013.
[25] Xu J, Wenzel J, Nolan MT, et al.Using Vignettes to Understand Heart Failure Self-care[J]. J Clin Nurs, 2018, 27(19-20):3554-3560. DOI:10.1111/jocn.14581.
[26] Seah ACW, Tan KK, Huang Gan JC, et al.Experiences of Patients Living with Heart Failure[J]. J Transcult Nurs, 2016, 27(4):392-399. DOI:10.1177/1043659615573840.
[27] Sano M, Majima T. Self-management of Congestive Heart Failure among Elderly Men in Japan[J]. Int J Nurs Pract, 2018,24(4) Suppl 1:e12653. DOI:10.1111/ijn.12653.
[28] 刘莉,王秀华,曹希,等.心力衰竭患者自我护理信心在领悟社会支持与自我护理行为间的中介作用[J].中国临床心理学杂志,2017,25(4):734-738. DOI:10.16128/j.cnki.1005-3611.2017.04.031.
[29] 李晓慧,章新琼,潘玉芹,等.益处发现在晚期肺癌患者灵性健康与乐观及自尊间的中介作用[J].护理学杂志,2020,35(6):67-71. DOI:10.3870/j.issn.1001-4152.2020.06.067.
[1] 贾莉莉, 张国增, 越丽霞, 朱康宁, 王志霞, 王飞杰. 临时性肠造口患者还纳术后居家生活体验的质性研究[J]. 护理学报, 2021, 28(2): 1-4.
[2] 刘庆伟, 邵美华, 赵亚玲, 尹霄朦, 姜园园, 朱秀丽. 间质性肺疾病患者健康信息获取行为的描述性质性研究[J]. 护理学报, 2021, 28(2): 47-51.
[3] 江丽玲, 詹梦梅, 黄秋霞, 李立群, 张淑, 龚晶晶, 王建宁. 乳腺癌患者性生活体验质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 33-37.
[4] 路莉静, 孟爱凤, 程芳, 邾萍, 智晓旭, 汤琳, 王鹏程. 乳腺癌患者就医延迟原因质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 38-44.
[5] 黄莉莉, 卜梦茹, 翟惠敏, 王映. 护理人文关怀实践困境的质性研究[J]. 护理学报, 2021, 28(1): 69-72.
[6] 王艳, 朱桂玲. 肠造口术后患者基于行为改变理论的护理干预效果观察[J]. 护理学报, 2020, 27(8): 54-58.
[7] 樊艳华, 邬要芬, 幸敏清. PICC带管出院患者基于ADOPT模式健康教育的效果观察[J]. 护理学报, 2020, 27(8): 73-76.
[8] 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.
[9] 王随琴, 关云, 李小妹. 社区护士主导多学科管理模式对糖尿病患者自我管理水平的影响[J]. 护理学报, 2020, 27(6): 9-11.
[10] 张文艳, 刘于, 张梦. 低收入人群高血压患病现状与自我管理的研究进展[J]. 护理学报, 2020, 27(6): 12-16.
[11] 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.
[12] 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.
[13] 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.
[14] 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.
[15] 白亚平. 思维导图在腹腔穿刺术后置管患者自我管理中的应用[J]. 护理学报, 2020, 27(3): 70-72.
Viewed
Full text


Abstract

Cited

  Shared   
[1] 贾莉莉, 张国增, 越丽霞, 朱康宁, 王志霞, 王飞杰. 临时性肠造口患者还纳术后居家生活体验的质性研究[J]. 护理学报, 2021, 28(2): 1 -4 .
[2] 程雪, 许翠萍, 张敏, 王君芝, 褚梁梁, 吴钰, 丁凯雯, 李长娥. 基于计划行为理论的无痛分娩意向自评量表构建[J]. 护理学报, 2021, 28(2): 5 -9 .
[3] 刘晓黎, 吴晓舟, 李硕, 杨国艺, 王泠, 刘树佳. 基于岗位胜任力的护士长分层培训体系构建[J]. 护理学报, 2021, 28(2): 10 -15 .
[4] 杜晓亮, 胡娜, 王倩云, 刘倩, 余星, 乐霄. 神经外科家庭参与式交班模式的实践[J]. 护理学报, 2021, 28(2): 16 -19 .
[5] 赵克迪, 王冉, 张瑛, 吴岚, 侯远征, 汤喆, 刘婷. 改良 SBAR 护理交接单在磁共振引导下脑肿瘤切除术患者交接班中的应用[J]. 护理学报, 2021, 28(2): 20 -23 .
[6] 孙叶, 杨寅, 王莹莹, 王天沛. 老年痴呆症患者预立医疗照护计划的研究进展[J]. 护理学报, 2021, 28(2): 24 -27 .
[7] 滕慧艳, 成华艳. 创造性故事疗法在老年痴呆患者的应用研究进展[J]. 护理学报, 2021, 28(2): 28 -30 .
[8] 郭汉画, 陈名桂, 孔丽丽, 张晓璇. 重症患者动脉测压导管最佳更换策略的循证实践[J]. 护理学报, 2021, 28(2): 37 -41 .
[9] 张庆玲, 佘兮, 董蕾, 褚玲玲, 许汝福. 神经性厌食症患者体育活动干预效果的系统评价[J]. 护理学报, 2021, 28(2): 42 -46 .
[10] 刘庆伟, 邵美华, 赵亚玲, 尹霄朦, 姜园园, 朱秀丽. 间质性肺疾病患者健康信息获取行为的描述性质性研究[J]. 护理学报, 2021, 28(2): 47 -51 .