Blaschke Sarah
Cancer Experiences Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Parkville, Melbourne, 3000, Australia.
Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
BMC Cancer. 2017 May 25;17(1):370. doi: 10.1186/s12885-017-3366-6.
A systematic review and meta-synthesis was conducted to identify, compare and synthesize the published qualitative literature contributing to our understanding of the role of nature in cancer patients' lives.
An electronic search of Medline, CINAHL, PsycINFO and Cochrane Databases was conducted to identify qualitative studies focused on cancer patients' nature experiences published between January 1985 and May 2015. Records were assessed according to pre-defined inclusion criteria. Data were extracted on study characteristics and evaluated using the COREQ guidelines for comprehensive quality reporting. Qualitative data from 'results' and 'findings' sections were entered into data management software NVivo in order to identify recurring themes and facilitate interpretation across studies.
From 11 eligible publications, seven inter-related core themes with descriptive themes were identified as follows: connecting with what is valued; being elsewhere, seeing and feeling differently; exploration, inner and outer excursions; home and safe; symbolism, understanding and communicating differently; benefitting from old and new physical activities; and, enriching aesthetic experiences.
Nature provides patients with unburdened physical and psychic space invested with personal significance. Findings propose nature's role as a "secure base" offering patients a familiar and nurturing context from which new perspectives can emerge and caring connections can be made with themselves, others, the past, and the future. As such, nature supported patients to navigate the clinical and personal consequences of cancer. Comprehensive representation of cancer patients' nature experiences identified patient values and care opportunities embedded in clinical and personal environments, which may be considered for future research and care service development.
进行了一项系统综述和元综合分析，以识别、比较和综合已发表的定性文献，从而增进我们对自然在癌症患者生活中作用的理解。
对Medline、CINAHL、PsycINFO和Cochrane数据库进行电子检索，以识别1985年1月至2015年5月期间发表的聚焦于癌症患者自然体验的定性研究。根据预先定义的纳入标准对记录进行评估。提取有关研究特征的数据，并使用COREQ综合质量报告指南进行评估。来自“结果”和“发现”部分的定性数据被录入数据管理软件NVivo，以识别反复出现的主题并促进跨研究的解读。
从11篇符合条件的出版物中，确定了七个相互关联的核心主题及描述性主题，如下所示：与珍视之物建立联系；身处别处，以不同方式看待和感受；探索，内心与外部的游历；家与安全；象征意义，以不同方式理解和交流；从新旧体育活动中受益；以及丰富审美体验。
自然为患者提供了充满个人意义的无负担的身心空间。研究结果表明，自然的作用是一个“安全基地”，为患者提供一个熟悉且滋养的环境，从中可以产生新的视角，并与自己、他人、过去和未来建立关怀联系。因此，自然帮助患者应对癌症的临床和个人影响。对癌症患者自然体验的全面呈现确定了临床和个人环境中蕴含的患者价值观和护理机会，未来研究和护理服务发展可予以考虑。
