Bally Jill M G, Smith Nicole R, Holtslander Lorraine, Duncan Vicky, Hodgson-Viden Heather, Mpofu Christopher, Zimmer Marcelline
College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.
College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada; Saskatoon Health Region, Saskatoon, SK, Canada.
J Pediatr Nurs. 2018 Jan-Feb;38:88-98. doi: 10.1016/j.pedn.2017.11.004. Epub 2017 Nov 27.
To conduct a metasynthesis of qualitative research exploring parents' psychosocial experiences during complex and traumatic life transitions related to caring for a child with a life-limiting (LLI) or life-threatening illness (LTI).
Parents' experiences of caring for a child impacted by an LLI or LTI are not clearly understood, and holistic, comprehensive pediatric nursing care for parents who have children with LLI and LTIs continues to be developed as treatment improves and survival is extended.
Predetermined inclusion and exclusion criteria were used to review qualitative studies. Those included were appraised, classified, and synthesized using systematic procedures guided by Sandelowski and Barroso (2006).
A systematic search of qualitative research was conducted by an experienced librarian to identify and retrieve studies from 10 databases.
Of the 3515 studies screened, 23 were included. A synthesis of the findings demonstrated that parents experience profound and pervasive uncertainty, leading to their own illness experience being described as a dual reality in which fighting for survival and recognizing the threat of their child's death were daily challenges. Three key processes emerged: the devastation of living with uncertainty, the emergence of hope, and moving forward.
The integration of findings adds to the current body of knowledge by highlighting the very complex experiences that parents undergo. These findings can support a more comprehensive pediatric nursing plan of care that accounts for the intricacies of the parental experience and the importance of hope.
对定性研究进行元综合分析，以探究父母在与照料患有危及生命（LLI）或有生命危险疾病（LTI）的孩子相关的复杂且创伤性的生活转变过程中的心理社会经历。
父母照料受LLI或LTI影响孩子的经历尚未得到清晰理解，随着治疗改善和生存期延长，针对有LLI和LTI孩子的父母的整体、全面儿科护理仍在不断发展。
使用预定的纳入和排除标准对定性研究进行综述。对纳入的研究采用由桑德洛斯基和巴罗斯（2006年）指导的系统程序进行评估、分类和综合。
一位经验丰富的图书馆员对定性研究进行系统检索，以从10个数据库中识别和检索研究。
在筛选的3515项研究中，纳入了23项。研究结果的综合表明，父母经历了深刻且普遍存在的不确定性，导致他们自己的疾病经历被描述为一种双重现实，其中为生存而战和认识到孩子死亡的威胁是日常挑战。出现了三个关键过程：与不确定性共存的毁灭感、希望的出现以及向前迈进。
研究结果的整合通过突出父母所经历的非常复杂的经历，丰富了当前的知识体系。这些结果可为更全面的儿科护理计划提供支持，该计划考虑到父母经历的复杂性以及希望的重要性。
