A Thematic Synthesis of the Experiences of Adults Living with Hemodialysis
A Thematic Synthesis of the Experiences of Adults Living with Hemodialysis
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DOI：
10.2215/cjn.10561015
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发表时间：
2016-07-01
影响因子：
9.8
通讯作者：
Jones, Colin
中科院分区：
文献类型：
--
作者：
Reid, Claire;Seymour, Julie;Jones, Colin
背景和目的中心内透析的患者在透析单元中花费了大量的时间；此外，ESRD的管理会影响透析单元外的许多方面的生活。为了改善对需要血液透析的患者的护理，必须了解他们关于治疗的经验和信念。设计、设置、参与者和测量我们检索了Embase、MEDLINE、CINAHL、心理学、Google Scholar和1995-2015年间发表的初步定性研究的参考文献列表，探讨成年患者接受中心血液透析治疗的经验。结果共纳入17项研究，涉及576名患者。开发了四个分析主题。第一个主题(一个新的透析依赖自我)描述了透析依赖可能导致的自我认同和自我认知的变化。第二个主题(受限的生活)描述了患者描述为依赖的结果的身体和情感限制。一些患者报告说，他们采取的策略使他们重新获得了对未来的乐观感和影响力，这些策略促成了第三个主题(重新获得控制权)。前三个主题描述了通过接受、适应和重新获得控制感来改变的可能性。最后一个主题(与卫生专业人员的关系)描述了这些关系对中心内患者的重要性，以及它们对权力和支持的感知的影响。这些关系通过信息共享、连续性和个性化支持影响了其他三个主题。结论我们的综合结果产生了一个框架，可以用于考虑干预措施，以改善患者的中心血液透析护理体验。将重点放在患者与其医疗保健专业人员之间已建立的关系中的干预措施上，可能会使患者逐步获得控制感，并提高对护理的满意度。
Background and objectives Patients on in-center dialysis spend significant amounts of time in the dialysis unit; additionally, managing ESRD affects many aspects of life outside the dialysis unit. To improve the care provided to patients requiring hemodialysis, their experiences and beliefs regarding treatment must be understood. This systematic review aimed to synthesize the experiences of patients receiving in-center hemodialysis.Design, setting, participants, & measurements We searched Embase, MEDLINE, CINAHL, PsychINFO, Google Scholar, and reference lists for primary qualitative studies published from 1995 to 2015 that explored the experiences of adult patients receiving treatment with in-center hemodialysis. A thematic synthesis was conducted.Results Seventeen studies involving 576 patients were included in the synthesis. Four analytic themes were developed. The first theme (a new dialysis dependent self) describes the changes in identity and perceptions of self that could result from dialysis dependence. The second theme (a restricted life) describes the physical and emotional constraints that patients described as a consequence of their dependence. Some patients reported strategies that allowed them to regain a sense of optimism and influence over the future, and these contributed to the third theme (regaining control). The first three themes describe a potential for change through acceptance, adaption, and regaining a sense of control. The final theme (relationships with health professionals) describes the importance of these relationships for in-center patients and their influence on perceptions of power and support. These relationships are seen to influence the other three themes through information sharing, continuity, and personalized support.Conclusions Our synthesis has resulted in a framework that can be used to consider interventions to improve patients' experiences of in-center hemodialysis care. Focusing on interventions that are incorporated into the established relationships that patients have with their health care professionals may enable patients to progress toward a sense of control and improve satisfaction with care.