Herber Oliver Rudolf, Bücker Bettina, Metzendorf Maria-Inti, Barroso Julie
1 Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
2 School of Health and Population Sciences, University of Birmingham, Edgbaston, England.
Eur J Cardiovasc Nurs. 2017 Dec;16(8):662-677. doi: 10.1177/1474515117711007. Epub 2017 May 16.
Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary.
The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques.
Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies. Meta-summary techniques include: (1) extraction of relevant statements of findings from each report; (2) reduction of these statements into abstracted findings and (3) calculation of effect sizes. Databases were searched systematically for qualitative studies published between January 2010 and July 2015. Out of 2264 papers identified, 31 reports based on the accounts of 814 patients were included in the meta-summary.
A total of 37 statements of findings provided a comprehensive inventory of findings across all reports. Out of these statements of findings, 21 were classified as barriers, 13 as facilitators and three were classed as both barriers and facilitators. The main themes relating to barriers and facilitators to self-care were: beliefs, benefits of self-care, comorbidities, financial constraints, symptom recognition, ethnic background, inconsistent self-care, insufficient information, positive and negative emotions, organizational context, past experiences, physical environment, self-initiative, self-care adverse effects, social context and personal preferences.
Based on the meta-findings identified in this study, future intervention development could address these barriers and facilitators in order to further enhance self-care abilities in heart failure patients.
个体定性研究针对心力衰竭患者未进行自我护理给出了各种原因,但汇总该主题的初步研究的文章存在方法学上的缺陷,这证明了进行定性元总结的合理性。
本研究的目的是运用元总结技术整合有关自我护理障碍和促进因素的定性研究结果。
采用桑德洛斯基和巴罗斯的定性元总结技术来整合定性研究的结果。元总结技术包括:(1)从每份报告中提取相关的研究结果陈述;(2)将这些陈述归纳为抽象的研究结果;(3)计算效应量。系统检索数据库,查找2010年1月至2015年7月发表的定性研究。在识别出的2264篇论文中,基于814名患者的描述的31份报告被纳入元总结。
总共37条研究结果陈述提供了所有报告中研究结果的全面清单。在这些研究结果陈述中,21条被归类为障碍,13条为促进因素,3条既被归类为障碍又被归类为促进因素。与自我护理障碍和促进因素相关的主要主题包括:信念、自我护理的益处、合并症、经济限制、症状识别、种族背景、自我护理不一致、信息不足、积极和消极情绪、组织环境、过去经历、物理环境、自我主动性、自我护理不良反应、社会环境和个人偏好。
基于本研究确定的元研究结果,未来的干预措施开发可以针对这些障碍和促进因素,以进一步提高心力衰竭患者的自我护理能力。