SCI晨读:影响护士为慢性病患者提供自我管理支持的因素:混合研究系统综述

2021
07/30

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自我管理支持是从事慢性病护理工作的护士的一项重要任务。自我管理支持的复杂性使得有必要澄清影响护士支持慢性病患者行为的因素。

SCI晨读:

影响护士为慢性病患者提供自我管理支持的因素:

混合研究系统综述

 



摘要

背景

自我管理支持是从事慢性病护理工作的护士的一项重要任务。自我管理支持的复杂性使得有必要澄清影响护士支持慢性病患者行为的因素。

目的

本综述的目的是综合影响护理慢性病患者的护士所认为的自我管理支持提供的因素。

设计

混合研究系统综述。

数据源

检索五个数据库:CINAHL、PubMed、Cochrane library、EMBASE 和Web of Science。纳入1999 年至 2020 年 4 月以英文发表的研究

综述方法

文献选择过程由 PICO(人口、兴趣现象和背景)指导。在前四种非传染性慢性病的背景下,突出强调了与护士提供自我管理支持相关的因素的研究也纳入在内。研究者仔细评估了偏倚风险。使用基于数据的收敛综合,综合确定的因素并制成表格。每个主题下的因素集群在讨论会上得到了所有研究人员的批准。

结果

共有 16 项研究符合纳入标准;其中,七项是定性研究、七项定量研究和两项混合方法研究。确定了护士对影响患者自我管理支持的因素,包括护士、护理关系、教育和培训、组织和医疗保健系统以及专业内和专业间水平。研究证据表明,这些因素本质上是相互依存的。

结论

建议考虑影响自我管理支持的相互依赖因素的框架。该框架强调需要对自我管理支持提出一个全面的定义,其中考虑到情感方面以及患者作为合作伙伴的方法。拟议的框架可用于定制多方面的干预措施,以加强护士在慢性病自我管理中的支持作用。未来的研究应侧重于探索影响护士在自我管理中的支持作用的情境相关因素。

Abstract

Background

Self-management support is considered an important task for nurses working in chronic care provision. The complex nature of self-management support makes it necessary to clarify the factors affecting the behaviour of nurses in supporting patients living with chronic illnesses.

Objective

The aim of this review is to synthesize the factors influencing the provision of self-management support as perceived by nurses in the care for patients living with a chronic illness.

Design

A systematic mixed studies review.

Data source

Studies published in English from 1999 to April 2020 were extracted from five databases: CINAHL, PubMed, Cochrane library, EMBASE, and Web of Science.

Review method

The selection process was guided by PICo (Population, phenomenon of Interest, and Context). Studies that highlighted factors associated with the provision of self-management support among nurses, within the context of the top four non-communicable chronic diseases, were included. The risk of bias was carefully assessed. Using data-based convergent synthesis, the identified factors were synthesized and tabulated. The clusters of factors organized under each theme were approved by all researchers in discussion meetings.

Results

In total, sixteen studies met the inclusion criteria; out of these, seven were qualitative, seven quantitative, and two mixed methods studies. The review identified nurses’ perspectives regarding factors influencing self-management support at the patient, nurse, care relationship, education and training, organization and healthcare system, and intra- and inter-professional levels. The review provided evidence that these factors are interdependent in nature.

Conclusion

This review proposed considering a framework of interdependent factors influencing self-management support. It highlighted the need to come up with a comprehensive definition of self-management support that takes into account the emotional aspect as well as patient-as-partner approach. The proposed framework can be useful in tailoring multi-faceted interventions to strengthen nurses’ supportive role in self-management of chronic care. Future studies should focus on exploring contextually relevant factors impacting nurses’ supportive role in self-management.



原文链接:https://doi.org/10.1016/j.ijnurstu.2021.103983


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关键词:
慢性病,SCI,护士,管理,研究

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