终末期病人配偶照护者需求的Meta整合

目的 系统评价和整合终末期病人配偶照护者的需求。方法 计算机检索PubMed、The Cochrane Library、Web of Science、MEDLINE、CINAHL、EMBase、Scopus、中国知网、CBM、万方、维普数据库,收集有关终末期病人配偶照护者需求的质性研究,检索时限为建库至2020年3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,运用汇集性整合方法对结果进行整合。结果 共纳入15篇文献,提炼出54个结果,归类成13个类属,合成3个整合结果。整合结果1是配偶持续需要通过家庭及专业支持获得身心、经济援助,包括3个类别：生理、安全、爱与归属;整合结果2是配偶发挥自我潜能,为积极治疗阶段的病人提供全面照顾的需求,包括4个类别：安全、爱与归属、尊重、自我实现;整合结果3是配偶为拒绝积极治疗/濒死阶段的病人做死亡准备,提升其死亡质量的需求,包括4个类别：安全、爱与归属、尊重、自我实现。结论 配偶在照顾终末期病人时存在各种各样的需求,政府、医疗机构、社区应重视疾病对配偶照护者的影响,了解并尊重其需求,为其提供物质和精神支持,从而提高照护能力和改善生活质量。     

护士对患者死亡认知与体验质性研究的Meta整合

目的 系统评价和整合护士对患者死亡认知与体验的质性研究。方法 计算机检索CNKI、万方、维普、CBM、PubMed、Embase、The Cochrane Library、Web of Science,收集关于护士对患者死亡认知、态度、感受和体验的质性研究,检索时限均为建库至2020年4月。采用澳大利亚JBI循证卫生保健中心（2017）质性研究质量评价标准进行评价,采用汇集性整合方法对结果进行整合。结果 共纳入14篇文献,提炼出115个研究结果,归纳相似研究结果形成8个新类别,得出4个整合结果,分别是：护士对患者死亡的感知;多种负性情绪应对策略;死亡经历对护士的影响;患者死亡时感知到的挑战和需求。结论 医疗护理管理者应重视护士对患者死亡的认知与体验,建立相关的支持教育系统提升其死亡应对能力,增强临终照护质量。     

晚期癌症患者照顾者心理体验质性研究的Meta整合

目的 分析与评价晚期癌症患者照顾者的心理体验。方法 检索Cochrane Library、乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库、Embase、PubMed、PsycINFO、Web of Science、CINAHL、中国知网、万方数据库、中国生物医学文献数据库,检索有关晚期癌症患者照顾者心理体验质性研究的文献,检索时限为建库至2018年11月,采用2016版澳大利亚JBI循证卫生保健中心质性研究质量评价标准进行文献质量评价,采用Meta整合方法对结果进行整合分析。 结果 共纳入8项研究,提炼44个结果,归纳成9个新的类别,综合成3个整合结果。①照顾者的负性心理问题：负性情绪表现,心理应激来源;②照顾者的正性心理感受：心理弹性增强,照顾角色强化,享受照顾过程,转变生死观念;③照顾者的心理支持需求：专业人士支持,同伴亲友支持,精神信仰支持。 结论 护理人员应重视照顾者的负性心理问题,发挥正性心理效应,帮助照顾者强化社会支持系统,满足其心理支持需求,从而提高照顾质量。     

帕金森病患者照顾者照护体验质性研究的Meta整合

目的 系统评价帕金森病患者主要照顾者的真实体验,为医院、社区更好地开展服务工作提供依据。方法 计算机检索PubMed、Web of Science、EBSCO、EMBase、Cochrane Library、中国知网、万方数据库、维普数据库,检索关于帕金森病患者主要照顾者真实体验的质性研究,检索时间从建库至2019年10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评价纳入文献质量,按照Meta整合方法进行整合与分析。结果 共纳入15篇相关文献,将研究结果重新归纳分类,提炼47个结果,将相似结果归纳组合形成8个新的类别,并综合成3个整合结果。整合结果1为照顾帕金森病患者给照顾者带来的影响,包括4个类别：经济负担、身体负担、心理负担、角色挑战;整合结果2为帕金森病患者照顾者的积极应对,包括2个类别：自我调节、胜任力建立;整合结果3为帕金森病患者照顾者的需求,包括2个类别：与帕金森病患者管理相关的需求、帕金森病患者照顾者自身需求。结论 照顾帕金森病患者给照顾者带来多方面的负担和影响,照顾者渴望信息等多方面的支持,在照顾过程中照顾者照护能力提升。政府、医疗机构、社区应重视帕金森病照顾者的真实感受和需求,为其提供针对性照护指导和支持性帮助,提高帕金森病患者及照顾者的生活质量。     

乳腺癌患者配偶照顾体验质性研究的Meta整合

目的 用系统评价的方法对乳腺癌患者配偶的照顾体验进行回顾,为居家延续性护理、整体性护理提供相应参考。方法 计算机检索PubMed、Web of Science、Cochrane Library、Science Direct、Springer、EBSCO、中国知网、万方数据库、中国生物医学文献数据库、维普数据库,筛选有关乳腺癌患者配偶照顾体验的质性研究的文献,检索时间从建库开始至2019年6月。利用Endnote X8版对文献进行筛选分析,按照澳大利亚JBI循证卫生保健中心质性研究质量评价标准进行文献质量评价后,采用Meta整合方式对研究结果进行归纳分析。结果 本研究共纳入19篇文献,从各研究中提取出73个清晰明确的结果,将相似研究结果进行整理汇编后形成13个新类别,3个整合结果。整合结果1：疾病扰乱了生活,包括7项类别情绪变化、角色改变、婚姻关系变化、性生活影响、经历艰难的工作处境、经济问题以及生活方式改变;整合结果2：寻求支持,包括3项类别内源性支持、外源性支持以及希望补充必要的信息支持;整合结果3：维持家庭稳定,包括3项类别明确希望的意义、找寻并建立希望和继续前行。结论 乳腺癌给患者及配偶的生活带来一系列正、负性体验,医务工作人员需深入配偶真实生活,了解其情感体验及相应需求,采取积极有效方式对配偶进行支持性干预,改善配偶不良情绪,加强正性体验,提高乳腺癌夫妻的生活质量。     

女性不孕症患者心理体验质性研究的Meta整合

目的: 系统评价女性不孕症患者心理体验的质性研究,为更好地制定心理干预方案提供理论依据。方法: 计算机检索Web of Science、PubMed、EMbase、The Cochrane Library及中国知网、维普、万方等数据库中与研究主题相符的质性研究文献,检索日期为建库到2020年12月,采用2016版澳大利亚循证卫生保健中心质性研究质量评价标准对文献进行质量评价,应用汇集性整合的方法进行Meta整合。结果: 共纳入9篇文献,提炼49个结果,归纳成6个新的类别,综合成3个整合结果。①不孕症患者的负性心理问题,包括负性情绪表现、心理压力来源;②不孕症患者的正性心理感受,包括坚定的信念、重新规划未来;③不孕症患者的心理支持需求,包括配偶亲属的支持、社会的支持、专业人士的支持。结论: 医务人员应重视不孕症患者的负性心理问题,重视不孕症患者的正性心理感受,构建并完善不孕症患者的社会支持系统满足其心理支持需求。     

国内痴呆症患者照顾者照护体验质性研究的Meta整合

目的 评价我国痴呆症患者照顾者的照护体验。方法 运用CNKI、VIP、WanFang Data、PubMed、EBSCO、EMBase、CINAHL Complete、Cochrane Library检索有关国内痴呆症患者照顾者照护体验的文献,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纳入文献质量,按照Meta整合方法对结果进行汇总。结果 共纳入11篇质性研究,总结出28个结果,概括为4个类别,最后提炼出2个整合结果。整合结果1：照顾者通过自我调节,角色适应能力逐渐增强。整合结果2：照顾者渴望得到家庭-医院-社区-社会的帮助和支持。结论 建立家庭-医院-社区-社会为一体的全面支持系统对于提高痴呆症患者及其照顾者的生活质量具有重要意义。     

痴呆症患者居家照顾者需求质性研究的Meta整合

目的 整合痴呆症患者居家照顾者需求的质性研究,为开展满足照顾者需求的干预研究,推动政策发展及服务改善提供可靠的依据。方法 检索The Cochrane Library、PubMed、CINAHL、EMBase、Scopus、PsycINFO、中国知网、万方、中国生物医学文献数据库（CMB）、维普数据库,自建库至2018年12月收录的关于痴呆症患者居家照顾者需求的质性研究。采用澳大利亚JBI循证卫生保健中心的质性研究评价标准进行文献质量评价,采用汇集性整合方法整合结果。结果 共纳入19项研究,提炼出62个完整明确的结果,经过归纳组合后形成6个新的类别,得到2个整合结果：与痴呆症患者管理相关的照顾者需求;照顾者自身需求。结论 需对痴呆症患者居家照顾者的实际需求,开展满足照顾者需求的干预研究,推动政策发展及服务改善。     

父母接受孤独症儿童诊断经历质性研究的系统评价

目的 系统评价父母接受孤独症儿童诊断的体验与感受,为建立完善的父母支持系统提供指导。方法 系统检索PubMed、CINAHL、PsycINFO、the Cochrane Library、Web of Science、EMBASE、中国知网、维普期刊数据库、中国生物医学文献数据库以及万方数据知识服务平台数据库,检索时限为建库至2020年8月,搜集关于父母接受孤独症儿童诊断经历的质性研究,并进行质量评价,结果整合。结果 共纳入11项研究,提炼41个研究结果,归纳总结后形成12个类别,3个整合结果：情感体验、信息需求以及获得支持。结论 政府及医疗保健人员应重视不同阶段父母对孤独症儿童诊断过程的感受与需求,给予医疗及政策支持,改善父母处境。     

老年人成功老龄态度质性研究的Meta整合

目的 系统评价老年人对成功老龄的态度及看法,为今后开展促进老年人成功老龄的干预提供参考依据。方法 检索中国知网、万方、维普、PubMed、CINAHL数据库,检索老年人对成功老龄态度和看法的质性研究的文献,检索时限从建库至2019年7月。采用澳大利亚Joanna Briggs循证卫生保健中心（JBI）质性研究真实性评价,采用汇集性整合方法进行整合。结果 纳入12篇文献,提炼出50个研究结果,将相关的结果归纳成14个类别,后将其综合成4个整合结果,分别为生理健康、心理健康与精神、社会幸福感、生命认知。结论 老年人对于成功老龄的态度和看法包括多个方面,政策制定者要充分认识到不同文化背景下老年人之间的差异,根据各自的文化背景,制定出相应的干预措施以促进老年人达到成功老龄。     

Spouses' conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction - A qualitative analysis.

BACKGROUND: Delay from onset of acute myocardial infarction symptoms to the delivery of medical care is a major determinant of prognosis. Although studies have explored patient reasons for delay, there are only limited data concerning experiences of the spouse. AIM: Was to describe spouses' conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction. METHOD: A phenomenographic approach was applied. Fifteen spouses were interviewed <48 h after the partner's hospital admittance. FINDINGS: Two categories with underlying sub-categories conceptualised the spouses' experiences. The category being resourceful contained: sharing the experience, having knowledge, understanding the severity, being rational, and consulting others. The category respecting independence contained: accepting the need for control, marital roles and experiences, restraining emotions, and seeking agreement. CONCLUSION: Our findings suggest that spouses have a strong influence on the course of events. When accepting the partner's need for control through following earlier marital roles and experiences, restraining own emotions and seeking agreement, this seemed to contribute to delay. However, when the spouse was resourceful by sharing the experience, having knowledge, understanding the severity, being rational and consulting others when needed, this seemed to have a positive influence on the pre-hospital time.     

Aphasia: its effect on marital relationships

The primary purpose of this study was to determine if a relationship exists between marital satisfaction and knowledge of aphasia of the spouse of a stroke patient. Other factors such as the severity of the aphasia, length of time poststroke, and length of marriage were also examined. The subjects, 16 spouses of aphasic patients, were grouped according to severity of the aphasia (mild, moderate, severe). Spouses completed a Knowledge of Aphasia questionnaire and pre/poststroke forms of a Marital Satisfaction Scale (MSS). The questionnaire measured spouse understanding of aphasia, while the MSS examined changes in spouse attitudes toward their marriages after the patients became aphasic. Neither spouses' knowledge of aphasia nor its severity was related to their marital satisfaction. However, there was a significant negative change between the pre/poststroke MSS scores. Spouses of mildly impaired patients were less knowledgeable about aphasia than were those of severely impaired patients. Results are discussed in terms of the counseling needs of families of aphasic patients.     

My love is hurting: the meaning spouses attribute to their loved ones' pain during palliative care

The purpose of this qualitative study was to develop our knowledge of the pain experiences of family members by addressing the meaning of cancer pain to the spouse of a patient receiving palliative care. In particular, this study explored factors associated with the meanings the spouses ascribe to the experience of pain during palliative care and whether the meanings the patients attributed to pain were similar to the meanings held by the spouse. Two different states emerged, the "in-pain state" and the "out of pain state". The spouses described feelings of helplessness, fear, and unfairness when witnessing their loved one in pain. Once the pain had been controlled, spouses described feelings of peace and relaxation, and felt this meant that the couple could return to their old routines because their spouse was still alive. It was discovered that the meanings placed on the cancer pain differed for the spouse and the patient, with the spouse focusing on future consequences. Implications and suggestions for nursing practice and future research are proposed.     

Caring for loved ones with frontotemporal degeneration: The lived experiences of spouses

There is an abundant literature about the experience of caregiving for a spouse living with Alzheimer's disease (AD), but there are very few qualitative studies about caregiving for persons living with Frontotemporal Degeneration (FTD). FTD causes a change in personality and affected persons may lose the ability to adhere to social norms. Thus, the emotional loss caregivers experience is often confounded by anger in response to embarrassing and socially inappropriate behaviors. In this paper, we offer a glimpse of this lived experience through the voices of two spouses whom we interviewed, each with experience caring for persons living with FTD. We suggest that FTD caregivers experience a loss of emotional attachment to their spouse because of their partner's behavioral symptoms. This loss gives rise to feelings of isolation and anger as caregivers assume new roles and reimagine their future. The findings from these interviews illuminate the need for more research and greater attention and support for FTD caregivers early in the disease trajectory.     

乳腺癌患者配偶照顾真实体验质性研究的Meta整合

目的：探讨乳腺癌患者配偶的照顾体验,全面了解患者配偶的内心需求,为更好的开展针对乳腺癌患者配偶的护理提供参考。方法：通过检索The Cochrane Library、Web of Science、PubMed以及中国知网、万方、维普数据库,纳入有关乳腺癌患者配偶照顾体验的质性研究文献,检索时限为建库至2019年11月。文献质量采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准,采取汇集性整合的方法进行结果整合。结果：共纳入12项研究,萃取出48个清晰准确的研究结果,将结果相似条目进行组合形成11个类别,且最终汇合成4个整合结果。结论：乳腺癌患者配偶在照顾过程中出现了身心问题困扰,夫妻关系破裂以及缺乏支持与应对等问题。医护人员在关注乳腺癌患者的同时,也要及时关注其配偶的心理变化和信息需要,提供必要的支持和帮助,从而提高照顾质量。     

Effects of advanced practice nursing on patient and spouse depressive symptoms, sexual function, and marital interaction after radical prostatectomy

A secondary analysis of a prospective randomized clinical trial with repeated measures was conducted to examine the effects of a standardized nursing intervention on patient and spouse depressive symptoms, sexual function, and marital interaction. Another purpose of this study was to determine if, over time, differences existed in men and their spouses' levels of depressive symptoms, sexual function, and marital interaction following radical prostatectomy. Spouses reported significantly higher levels of depressive symptoms and significantly more marital interaction distress compared to patients. Patients reported significantly more distress pertaining to sexual function than their spouses.     

Chronic headache patients' marital and family adjustment

The purpose of this study was to compare the marital and family adjustment of headache patients and their spouses, before pain control treatment, to couples without chronic pain. Minuchin's (1978) family systems theory of psychosomatic illness was tested, using an adult sample. This sample consisted of 117 headache-patient-and-spouse couples and a control group of 108 married couples without chronic pain. A survey design was used with marital and family assessment instruments. Marital and family questionnaires were given to headache patients and their spouses before beginning treatment and were sent to couples without chronic pain. "Headache couples" reported greater differences in consensus, cohesion, affection, and sexual relationships than did control couples. Headache patients reporting greater marital adjustment were more likely to have continuous pain than those reporting less marital adjustment. Headache patients' pain per day correlated positively with greater family cohesion and adaptability. Headache patients' severity of pain correlated positively with greater marital affection. The spouses' marital cohesion, affection, and family cohesion and adaptability correlated positively with increased severity of patients' pain.