身体虚弱的肾透析患者的生活质量：改善医疗保健的困难和资源的定性综合

IF 3.1 3区医学 Q1 NURSING

International Journal of Nursing Sciences Pub Date : 2025-07-01 DOI:10.1016/j.ijnss.2025.06.012

Anabel Ramírez-García , Alba Torné-Ruiz , Aida Bonet , Olga Monistrol , Marta Banqué , Judith Roca

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引用次数: 0

摘要

目的本研究旨在总结接受血液透析或腹膜透析的身体虚弱个体的生活质量体验，并确定其困难和资源，以实现更好的以人为本的卫生保健。方法采用定性综合方法进行文献综述。通过医学主题词和免费术语在CINAHL、Scopus、PubMed、Web of Science、Cochrane Library和Cuiden Plus等数据库中进行搜索。定性和混合研究纳入了2013年1月至2024年1月期间以英语或西班牙语发表的18岁或以上接受血液透析或腹膜透析的个体。使用混合方法评估工具评估方法学质量。通过社会生态模型和健康的社会决定因素对这些信息进行了分析和编码。结果选取定性文献14篇，混合文献2篇。共有256人参与了这项研究。确定了17个主题和25个分主题，并将其分为两个部分（困难和资源）。突出的困难是对日常生活活动和体力活动的容忍度低，对生活和社会角色失去自我控制，缺乏社区和公共资源。在资源方面，我们发现透析的积极意义、亲密个体和医疗团队提供的安全性、特定项目的激活以及以人为本的政策。结论通过对已确定的困难和资源的分析和解释，揭示了为透析患者设计和实施健康方案时需要考虑的关键因素。未来的研究应在不同的文化和地理背景下探索这些维度，以增强概括性并支持卫生公平。

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Quality of life experience in physically frail people on renal dialysis: A qualitative meta-synthesis on the difficulties and resources for better health care

Objective

This study aimed to summarize the quality of life experiences of individuals with physical frailty undergoing hemodialysis or peritoneal dialysis and to identify the difficulties and resources that enable better person-centered health care.

Methods

The study described is a qualitative meta-synthesis literature review. The search was performed in databases such as CINAHL, Scopus, PubMed, Web of Science, the Cochrane Library, and Cuiden Plus through Medical Subject Headings and free terms. Qualitative and mixed studies were included on individuals undergoing hemodialysis or peritoneal dialysis, 18 years of age or older, published in English or Spanish, between January 2013 and January 2024. The Mixed Methods Appraisal Tool was used to assess the methodological quality. The information was analyzed and coded through a socioecological model and the social determinants of health.

Results

Fourteen qualitative and two mixed articles were selected. A total of 256 individuals participated in the study. Seventeen themes and 25 sub-themes were identified and grouped into two blocks (difficulties and resources). The difficulties that stood out were a low tolerance for activities of daily living and physical activity, loss of self-control over life and social roles, and lack of community and public resources. As for the resources, the following was found: the positive meaning of dialysis, the safety offered by close individuals and the healthcare team, the activation of specific programs, and person-centered policies.

Conclusions

The analysis and interpretation of the identified difficulties and resources revealed key elements to consider when designing and implementing health programs for individuals undergoing dialysis. Future research should explore these dimensions in diverse cultural and geographical contexts to enhance generalizability and support health equity.

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来源期刊

International Journal of Nursing Sciences Nursing-Nursing (all)

CiteScore

6.10

自引率

2.60%

发文量

408

审稿时长

25 days

期刊介绍： This journal aims to promote excellence in nursing and health care through the dissemination of the latest, evidence-based, peer-reviewed clinical information and original research, providing an international platform for exchanging knowledge, research findings and nursing practice experience. This journal covers a wide range of nursing topics such as advanced nursing practice, bio-psychosocial issues related to health, cultural perspectives, lifestyle change as a component of health promotion, chronic disease, including end-of-life care, family care giving. IJNSS publishes four issues per year in Jan/Apr/Jul/Oct. IJNSS intended readership includes practicing nurses in all spheres and at all levels who are committed to advancing practice and professional development on the basis of new knowledge and evidence; managers and senior members of the nursing; nurse educators and nursing students etc. IJNSS seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Contributions are welcomed from other health professions on issues that have a direct impact on nursing practice.