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] 李疆伟, 王树君, 李长仔, 胡宝山, 焦桂梅, 张卫红. 基于压力应对理论的护理干预对结直肠癌术后永久性肠造口患者心理压力、负性情绪及自我管理的影响[J]. 护理学报, 2025, 32(4): 64-69.
[2] 吴超瑜, 刘尚昆. 麻醉恢复室护士危机管理能力的质性研究[J]. 护理学报, 2025, 32(3): 17-21.
[3] 谭雯渲, 张容, 张立力, 王玮, 邵艳红, 方庆虹, 朱瑾. 心脏移植患者手术决策困境的现象学研究[J]. 护理学报, 2025, 32(3): 69-73.
[4] 杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12.
[5] 曹敏, 张培莉, 侯晓雅, 高超越, 郭林芳, 李滢. ABC-X模型下结直肠癌化疗患者照顾者营养照护体验的质性研究[J]. 护理学报, 2025, 32(2): 13-18.
[6] 孙娟, 李亚莉, 马安娜, 王华, 张会敏. 护理研究生对社区护理实践思政教学体验的质性研究[J]. 护理学报, 2025, 32(1): 19-23.
[7] 王语, 赵慧杰, 肖梦伟, 范硕宁, 孙佳丽, 王珂心, 苏炫, 杨滢瑞. 糖尿病视网膜病变患者硅油填充期间疾病体验与应对的质性研究[J]. 护理学报, 2025, 32(1): 68-72.
[8] 陈洁, 孟庆童, 刘惊今, 吴艳妮. 基于指南的慢性心力衰竭患者运动康复科普手册研制[J]. 护理学报, 2024, 31(9): 36-41.
[9] 叶香, 黎楷, 黄敏, 张倩, 李际敏, 刘荣珍, 孟敏, 朱少玉, 谢翠华. 对成年2型糖尿病患者基于移动APP+家属共管血糖的研究[J]. 护理学报, 2024, 31(9): 60-65.
[10] 冯春玲, 胡夏晴, 徐琳, 蔡鑫健, 徐琴鸿. 基于社会生态系统理论的电话指导公众实施心肺复苏行为动机及需求的质性研究[J]. 护理学报, 2024, 31(9): 66-71.
[11] 曹依丽, 王玲, 王灿, 陈燕华, 秦虹云. 精神分裂症住院患者家属资源取向的质性研究[J]. 护理学报, 2024, 31(8): 74-78.
[12] 马瑞瑞, 范晓莉, 徐姝娟, 张伟, 陈婷, 谈飞飞. 护士参与终末期患者临终决策体验的质性研究[J]. 护理学报, 2024, 31(7): 6-11.
[13] 赵洁, 宋雅玲, 畅盼, 郭倩, 王锦华. 慢性心力衰竭患者及其照顾者心理弹性在疾病不确定感与生活质量间的主客体互倚中介模型研究[J]. 护理学报, 2024, 31(7): 17-21.
[14] 龙瑶, 卢春凤, 冯志仙. 临床护士对横向领导者特质感知的质性研究[J]. 护理学报, 2024, 31(7): 27-31.
[15] 张颖, 车晓艳, 万婠, 秦雪, 张恩思, 崇武, 郑淑娟. 我国性治疗护士工作范畴和核心能力的质性研究[J]. 护理学报, 2024, 31(7): 68-72.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!