家庭成员在照顾慢性阻塞性肺疾病患者时对自我管理咨询的经验和期望:对定性证据的系统回顾

Hannele Siltanen, Virpi Jylhä, A. Holopainen, E. Paavilainen
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引用次数: 7

摘要

目的:本综述的目的是识别和综合现有的关于慢性阻塞性肺疾病(COPD)患者的成年家庭成员的经验和自我管理咨询的期望的证据,这些成年家庭成员是慢性阻塞性肺疾病(COPD)患者住院或门诊护理的非正式照护者。慢性阻塞性肺疾病是全球第四大死亡和发病原因。这是一种进行性的、终生的、不可预测的疾病。随着病情的发展,慢性阻塞性肺病患者及其家庭成员都需要信息和实用技能来控制疾病。在慢性阻塞性肺病晚期,家庭成员的作用尤为重要。本系统回顾调查了家庭成员的经验和自我管理咨询的期望。纳入标准:本综述纳入了调查成人(18岁以上)家庭成员在住院或门诊治疗中COPD自我管理咨询的经历或期望的定性研究。“家庭成员”是指由于与慢性阻塞性肺病患者的关系而成为非正式照顾者的人。方法采用三步搜索策略。搜索策略旨在查找英语和芬兰语的已发表和未发表的研究。检索数据库MEDLINE、CINAHL、PsycINFO、SCOPUS和芬兰医学书目数据库(Medic)。该调查于2015年12月进行,并于2018年9月更新。题目和摘要由两位独立的审稿人筛选,以确定综述的纳入标准。然后由两名独立评审员对符合条件的研究进行方法学质量的严格评价。研究结果和对研究结果的说明被提取出来,并被赋予一定程度的可信度。采用meta-aggregation的JBI方法对定性研究结果进行汇总。结果共有10篇论文被纳入本综述。这些研究发表于2002年至2017年。所有纳入研究的质量至少为中等。每个研究在JBI定性研究关键评估清单上的总分在7到10之间。以下四项综合结果来自9个类别和39项研究结果:i)家庭成员对卫生专业人员反应迟钝的经历,ii)家庭成员在自我管理咨询中未满足需求的经历,iii)家庭成员对COPD管理的信息需求,iv)家庭成员对应对策略的信息需求。结论综合调查结果表明,家庭成员对自我管理咨询的不足感到沮丧。他们也对自己的照顾角色感到没有准备和不确定。他们需要更多关于慢性阻塞性肺病和应对策略的信息。咨询对于高质量的护理是必不可少的,应该提供给照顾处于COPD任何阶段的亲人的家庭成员。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Family members' experiences and expectations of self-management counseling while caring for a person with chronic obstructive pulmonary disease: a systematic review of qualitative evidence.
OBJECTIVE The objective of this review was to identify and synthesize existing evidence on the experiences and expectations of self-management counseling of adult family members who are informal caregivers of a person with chronic obstructive pulmonary disease (COPD) in the context of inpatient or outpatient care. INTRODUCTION Chronic obstructive pulmonary disease is the fourth leading cause of mortality and morbidity worldwide. It is a progressive, lifelong and unpredictable disease. As the disease progresses, both the people with COPD and their family members require information and practical skills to manage the disease. The role of family members is particularly important at an advanced stage of COPD. This systematic review examined family members' experiences and expectations of self-management counseling. INCLUSION CRITERIA This review considered qualitative studies that investigated adult (older than18 years) family members' experiences or expectations of COPD self-management counseling in the context of inpatient or outpatient care. "Family member" refers to a person who is an informal caregiver because of his or her relationship to the person with COPD. METHODS A three-step search strategy was utilized in this review. The search strategy aimed to find published and unpublished studies in English and Finnish. The databases MEDLINE, CINAHL, PsycINFO, SCOPUS and Finnish medical bibliographic database (Medic) were searched. The search was conducted in December 2015 and updated in September 2018. Titles and abstracts were screened by two independent reviewers for the review's inclusion criteria. Eligible studies were then critically appraised by two independent reviewers for methodological quality. The findings and the illustrations of the findings were extracted and assigned a level of credibility. The qualitative research findings were pooled using the JBI method of meta-aggregation. RESULTS A total of 10 papers were selected for inclusion in this review. These studies were published from 2002 to 2017. The quality of all included studies was at least moderate. Each study had a total score between 7 and 10 on the JBI Critical Appraisal Checklist for Qualitative Research. The following four synthesized findings were aggregated from nine categories and 39 study findings: i) Family members' experiences with unresponsive behavior from health professionals, ii) Family members' experiences of unmet needs in self-management counseling, iii) Family members' information needs concerning COPD management and iv) Family members' information needs concerning coping strategies. CONCLUSIONS The synthesized findings indicate that family members are frustrated by the shortcomings of self-management counseling. They also feel unprepared for and uncertain about their caring role. They need more information about COPD and coping strategies for COPD. Counseling is essential to high-quality care and should be offered to family members caring for a loved one at any stage of COPD.
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