| 陈丽梅,苟昕雨,吴静.患方对于植入型心律转复除颤器关闭体验的质性研究Meta整合[J].上海护理,2025,25(6): |
| 患方对于植入型心律转复除颤器关闭体验的质性研究Meta整合 |
| Meta-synthesis of qualitative research on patient's and relatives experience of implantable cardioverter defibrillator deactivation |
| DOI： |
| 中文关键词: 关闭ICD除颤 患方偏好 安宁疗护 预立医疗照护计划 质性研究 Meta 整合 |
| 英文关键词:ICD Deactivation Patient Preferences Hospice Care Advance Care Planning Qualitative Research Meta-synthesis |
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| 中文摘要: |
| 目的 系统整合患方就临终前植入型心律转复除颤器（ICD）关闭除颤功能决策的现状及阻碍因素，以优化决策支持策略，提高临终患者的舒适度和护理质量。方法 计算机检索中国知网、中国生物医学文献数据库、万方数据库、Web of Science、PubMed、Embase数据库中有关患方对于临终关闭ICD的偏好与体验的质性研究；检索时限为建库至 2024年 1月10日。采用2016版澳大利亚乔安娜布里格斯研究所（JBI）循证卫生保健中心质性研究质量评价标准进行文献质量评价。 结果 共纳入12篇文献，共提炼出完整的研究主题36个，归纳组合形成4个类别、3个整合结果。整合结果1：患者决策特征及医患协作需求；整合结果2：家属决策困境与医患沟通优化路径；整合结果3：ICD认知偏差对医疗决策的影响。结论 患者选择关闭ICD的主因原因是电击痛苦与家属负担；然而，对家属而言，关闭ICD的决策十分的痛苦。结果强调了从业人员对于患者设备知识普及以及临终关于ICD关闭讨论的必要性。 |
| 英文摘要: |
| Objective To integrate qualitative studies on the decision-making process regarding the deactivation of ICD defibrillator functions in end-of-life care, focusing on identifying current trends and obstacles in patients' decisions. Methods Search of six databases, including CNKI, Wanfang, SinoMed, Web of Science, Embase, PubMed was carried out on qualitative researches on the preferences and experiences of ICD, CRT-D, S-ICD patients and their relatives towards end-of-life ICD deactivation; The time span of the search was from the establishment of each database to January 10, 2024. Quality evaluation of the articles that meet the requirements was conducted using the qualitative research quality evaluation standards of the Australian Joanna Briggs Institute Evidence Based Health Care Center, and the interview materials were further integrated and analyzed. Results A total of 12 studies were included, resulting in 4 subcategories, which were synthesized into 3 integrated findings: emotional and psychological conflicts faced by both patients and families during ICD deactivation decision-making, preferences of both patients and families during the decision process, and the exaggeration and misunderstanding of the device functions by patients and families. Conclusion The primary reasons for patients choosing to deactivate ICDs are the physical pain caused by defibrillation and the burden on their family members. However, for families, making the decision to deactivate the ICD can be emotionally challenging. The findings highlight the importance of educating patients about ICD functionality and the necessity of discussing ICD deactivation during the end-of-life phase. |
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