School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL, United Kingdom.
World J Gastroenterol. 2012 Nov 21;18(43):6240-9. doi: 10.3748/wjg.v18.i43.6240.
To undertake a metasynthesis of qualitative studies to understand the health and social needs of people living with inflammatory bowel disease (IBD).
A systematic search strategy identified qualitative studies exploring the phenomenon of living with inflammatory bowel disease. Databases included MEDLINE, PsychInfo, EMBASE, CINAHL and the British Nursing Index via the OVID platform. Qualitative search filters were adapted from Hedges database (http://www.urmc.rochester.edu/hslt/miner/digital_library/tip_sheets/Cinahl_eb_filters.pdf). Qualitative empirical studies exploring the health and social needs of people living with inflammatory bowel disease were selected. Study eligibility and data extraction were independently completed using the Critical Appraisal Skills Programme for qualitative studies. The studies were analysed and synthesised using metasynthesis methodology. The themes from the studies allowed for common translations into a new interpretation of the impact of living with inflammatory bowel disease.
Of 1395 studies, six published studies and one unpublished thesis fulfilled the inclusion criteria. First iteration of synthesis identified 16 themes, 2nd iteration synthesised these into three main 2nd order constructs: "detained by the disease"; "living in a world of disease" and "wrestling with life". "Detained by the disease" is the fear of incontinence, the behaviour the patients display due to the fear, and the impact this has on the individual, such as social isolation and missing out on life events. All of these serve to "pull" the patient back from normal living. "Living in a world of disease" is the long term effects of living with a long term condition and the fear of these effects. "Wrestling with life" is the continued fight to thrive, the "push" to continue normal living.
The metasynthesis provides a comprehensive representation of living with IBD. The unmistakeable burden of incontinence is exposed and its ongoing effects are demonstrated. The combined overall impact of living with IBD is the tension these patients live with: "Pushed and pulled: a compromised life", people living with IBD experience a constant conflict throughout their lives, they push to be normal but IBD pulls them back. The impact of the fear of incontinence and behaviour of the individual as a result, requires further qualitative enquiry.
对定性研究进行综合分析，以了解炎症性肠病（IBD）患者的健康和社会需求。
采用系统检索策略，确定了探索炎症性肠病患者生活现象的定性研究。数据库包括 MEDLINE、PsychInfo、EMBASE、CINAHL 和通过 OVID 平台的英国护理索引。定性搜索过滤器改编自 Hedges 数据库（http://www.urmc.rochester.edu/hslt/miner/digital_library/tip_sheets/Cinahl_eb_filters.pdf）。选择了探索炎症性肠病患者健康和社会需求的定性实证研究。使用定性研究的批判性评价技能方案独立完成研究的资格和数据提取。使用综合分析方法对研究进行分析和综合。研究中的主题允许进行共同翻译，以对炎症性肠病患者生活的影响进行新的解释。
在 1395 项研究中，有 6 项已发表的研究和 1 项未发表的论文符合纳入标准。综合分析的第一次迭代确定了 16 个主题，第二次迭代将这些主题综合成三个主要的二阶结构：“被疾病所困”；“生活在疾病的世界中”和“与生活作斗争”。“被疾病所困”是指对失禁的恐惧，患者因恐惧而表现出的行为，以及对个人的影响，如社交孤立和错过生活事件。所有这些都使患者无法正常生活。“生活在疾病的世界中”是指长期患有慢性病的长期影响，以及对这些影响的恐惧。“与生活作斗争”是指继续奋斗，“推动”继续正常生活。
综合分析提供了炎症性肠病患者生活的全面描述。不可避免的失禁负担被暴露出来，其持续影响也得到了证明。炎症性肠病患者生活的综合影响是他们生活中的这种紧张关系：“被推和拉：生活受到影响”，患有炎症性肠病的患者一生都在经历着持续的冲突，他们努力使自己正常，但炎症性肠病又将他们拉回现实。对失禁恐惧和个人行为的影响需要进一步的定性研究。
