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从维持生命治疗到维持生命治疗的转变体验:系统文献回顾。

The experience of transitioning into life-sustaining treatment: A systematic literature review.

机构信息

Department of Nephrology, Karlskoga Hospital, Karlskoga, Sweden.

Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.

出版信息

J Ren Care. 2023 Sep;49(3):158-169. doi: 10.1111/jorc.12439. Epub 2022 Aug 6.

Abstract

BACKGROUND

Being informed about treatment options for kidney failure and included in the related decision-making process can facilitate a smooth transition. Among patients with kidney failure the initiation of kidney failure replacement therapy is considered a traumatic event, causing physical and emotional distress and disrupting several aspects of one's social life. In order to ease the transition, health care personnel must ensure that the patient understands the parameters of each treatment option. It is imperative to increase the knowledge of patients' lived experiences around initiating kidney failure replacement therapy.

OBJECTIVES

To explore how adults with kidney failure describe the lived experience of transitioning into life-sustaining kidney failure replacement therapy.

DESIGN

A systematic review of qualitative literature.

METHODS

Primary qualitative studies published in English between 2010 and 2020 from CINAHL, PubMed and PsycINFO were included. Content analysis summarised the patients' lived experience.

FINDINGS

From 959 records screened, 17 studies were eligible for inclusion. A total of 5 themes that described the patients' lived experience were identified: an existential transformative feeling, a change in quality of life, limitation, safety, and ambivalence.

CONCLUSION

Being prepared and receiving emotional, physical, and social support can ease the transition for the patient. Among all available treatment options, dialysis and transplantation, the transition into kidney failure replacement therapy is experienced as a life-changing event. With this knowledge, it is imperative to clarify the importance of providing a patient with adequate support during the transition.

摘要

背景

了解肾衰竭的治疗选择并参与相关决策过程可以促进平稳过渡。对于肾衰竭患者来说,开始肾衰竭替代治疗被认为是一个创伤性事件,会导致身体和情绪上的痛苦,并扰乱社交生活的多个方面。为了顺利过渡,医护人员必须确保患者了解每种治疗选择的参数。增加患者对开始肾衰竭替代治疗的生活体验的了解至关重要。

目的

探讨肾衰竭患者如何描述过渡到维持生命的肾衰竭替代治疗的生活体验。

设计

对 2010 年至 2020 年间发表的英文原始定性研究进行系统综述。

方法

从 CINAHL、PubMed 和 PsycINFO 中纳入符合条件的初级定性研究。内容分析总结了患者的生活体验。

结果

从筛选出的 959 条记录中,有 17 项研究符合纳入标准。确定了描述患者生活体验的 5 个主题:存在的转变感、生活质量的变化、限制、安全和矛盾心理。

结论

做好准备并获得情感、身体和社会支持可以缓解患者的过渡。在所有可用的治疗选择中,透析和移植,过渡到肾衰竭替代治疗被体验为改变生活的事件。有了这些知识,就必须明确在过渡期间为患者提供充分支持的重要性。

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