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。

Experience of Spouse Caregivers in Caring for Patients in Terminal Stage: A Meta Integration

Objective To systematically review and synthesize the need of spouse caregivers in caring for patients in terminal stage. Methods We searched databases including PubMed, The Cochrane Library, Web of Science, MEDLINE, CINAHL, EMBase, Scopus, CNKI, CBM, Wanfang Data, VIP from the inception to March 2020, to collect qualitative studies of spouse caregivers' needs in caring for patients in terminal stage. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies (2017 edition) in Australia. The results were integrated using the pooled integration approach. Results We obtained 15 qualified studies. There were 54 findings classified into 13 categories, and then finally 3 integrated synthesized results were obtained as follows: 1. The spouse caregivers' ongoing need for physical, mental, and financial support through family and professional support included 3 categories: physiological, safety, love and belonging needs; 2. The spouse caregivers made their best to provide comprehensive care for patients in active treatment stage, which included 4 categories: safety, love and belonging, esteem, and self-actualization needs; 3.The spouse caregivers′ need to prepare for and improve the quality of patients refusing active treatment or in dying stage included 4 categories: safety, love and belonging, esteem, and self-actualization needs. Conclusion There are various needs of spouse caregivers in caring for patients in terminal stage. The government, medical institutions and the community should pay attention to the impact of diseases on spouse caregivers, and provide them with material and mental support, so as to improve the ability of care and quality of life.