Experiences of long-term life-limiting conditions among patients and carers: what can we learn from a meta-review of systematic reviews of qualitative studies of chronic heart failure, chronic obstructive pulmonary disease and chronic kidney disease?
Experiences of long-term life-limiting conditions among patients and carers: what can we learn from a meta-review of systematic reviews of qualitative studies of chronic heart failure, chronic obstructive pulmonary disease and chronic kidney disease?
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DOI：
10.1136/bmjopen-2016-011694
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发表时间：
2016-10-05
期刊：
影响因子：
2.9
通讯作者：
Richardson A
中科院分区：
文献类型：
--
作者：
May CR;Cummings A;Myall M;Harvey J;Pope C;Griffiths P;Roderick P;Arber M;Boehmer K;Mair FS;Richardson A
总结和综合已发表的定性研究，以确定影响慢性心力衰竭（CHF）、慢性阻塞性肺疾病（COPD）和慢性肾脏疾病（CKD）患者和护理人员经历的因素。定性系统综述和元综述的元综述。使用内容分析法分析的论文。检索了2000年1月至2015年4月期间的CINAHL、EMBASE、MEDLINE、PsychINFO、Scopus和Web of Science。系统性综述和定性荟萃分析，参与者为患者、护理人员，描述了年龄≥18岁的CHF、COPD和CKD在初级和二级护理中的护理经验。 检索了5420篇文章，其中53篇符合纳入标准。回顾表明，病人和照顾者的求助和决策是由他们的结构优势程度（社会经济地位，空间位置，卫生服务质量），他们的干扰优势程度（认知优势，情感状态和互动质量）和他们的结构弹性程度（适应逆境，能力管理护理和照顾者对需求的反应）。据我们所知，这是该领域的第一个定性系统评价的综合。本综述的一个重要结果是强调患者和护理人员的价值，以及影响CHF、COPD和CKD病理生理恶化的不良影响和后果的医疗保健系统、关系和实践的属性。试图赋予个别患者权力的干预措施，对于那些受本概述中确定的结构性、关系性和实际不利因素综合影响最大的人来说，效果可能有限。我们确定了可以解决这些缺点的干预措施的潜在目标。PROSPERO CRD 42014014547。
To summarise and synthesise published qualitative studies to characterise factors that shape patient and caregiver experiences of chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). Meta-review of qualitative systematic reviews and metasyntheses. Papers analysed using content analysis. CINAHL, EMBASE, MEDLINE, PsychINFO, Scopus and Web of Science were searched from January 2000 to April 2015. Systematic reviews and qualitative metasyntheses where the participants were patients, caregivers and which described experiences of care for CHF, COPD and CKD in primary and secondary care who were aged ≥18 years. Searches identified 5420 articles, 53 of which met inclusion criteria. Reviews showed that patients' and caregivers' help seeking and decision-making were shaped by their degree of structural advantage (socioeconomic status, spatial location, health service quality); their degree of interactional advantage (cognitive advantage, affective state and interaction quality) and their degree of structural resilience (adaptation to adversity, competence in managing care and caregiver response to demands). To the best of our knowledge, this is the first synthesis of qualitative systematic reviews in the field. An important outcome of this overview is an emphasis on what patients and caregivers value and on attributes of healthcare systems, relationships and practices that affect the distressing effects and consequences of pathophysiological deterioration in CHF, COPD and CKD. Interventions that seek to empower individual patients may have limited effectiveness for those who are most affected by the combined weight of structural, relational and practical disadvantage identified in this overview. We identify potential targets for interventions that could address these disadvantages. PROSPERO CRD42014014547.
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DOI：
10.1097/jcn.0b013e318273a5d6
发表时间：
2014-01
期刊：
The Journal of cardiovascular nursing
影响因子：
--
作者：
Dekker RL
通讯作者：
Dekker RL
影响因子：
3.7
作者：
Boger E;Ellis J;Latter S;Foster C;Kennedy A;Jones F;Fenerty V;Kellar I;Demain S
通讯作者：
Demain S
影响因子：
16.2
作者：
Bohlen, Krista;Scoville, Elizabeth;Montori, Victor M.
通讯作者：
Montori, Victor M.
影响因子：
4.1
作者：
Cullen, D L;Stiffler, D
通讯作者：
Stiffler, D
影响因子：
2.9
作者：
Buck, Harleah G.;Harkness, Karen;Arthur, Heather M.
通讯作者：
Arthur, Heather M.