有自杀风险成年人的成年非正式照料者的经历与需求：一项采用混合方法分析的系统综述
Experiences and needs of adult informal carers of adults at risk of suicide: A systematic review with mixed methods analysis.
作者信息
Lascelles Karen Moya, Davey Zoe, Jackson Debra, Aveyard Helen
机构信息
Oxford Health NHS Foundation Trust, Oxford Brookes University, Oxford, UK.
Oxford Institute of Nursing Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK.
出版信息
J Adv Nurs. 2024 May;80(5):1686-1718. doi: 10.1111/jan.15940. Epub 2023 Nov 27.
AIM
To systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide.
DESIGN
Systematic review with a data-based convergent synthesis.
DATA SOURCES
MEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included.
METHODS
Articles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty-one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis.
RESULTS
Five interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported.
CONCLUSION
Timely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts.
IMPLICATIONS
Nurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved.
IMPACT
Findings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers.
PATIENT OR PUBLIC CONTRIBUTION
There was no patient or public contribution.
目的
系统回顾和综合关于有自杀风险成年人的成年非正式照料者的经历和需求的原始研究。
设计
基于数据的收敛性综合的系统回顾。
数据来源
于2022年4月和2023年2月检索了MEDLINE、PsychINFO和CINAHL。纳入了关注成年照料者经历的英文研究。
方法
通过标题（n = 9077）和摘要（n = 132）筛选文章，并通过引用和手工检索获得额外的文章（n = 6）。使用混合方法评估工具对31项纳入研究进行质量评估，并在主题综合之前系统提取研究数据。
结果
产生了五个相互关联的主题：转变；生活在恐惧和不确定性中；关系的变化；与医疗保健专业人员和服务的接口；照料者的需求和期望。照料会影响心理、身体和社会福祉。关系受到的影响在照料未成年人时可能不明显。反复的自杀行为特别具有挑战性，持续的过度警惕会导致负担、倦怠和人际压力。对照料者的支持不足会加剧负面影响；照料者需要感到了解情况、受到教育参与其中并得到全面支持。
结论
及时为照料者提供支持至关重要。干预措施应解决情绪反应、关系变化和对照料接受者的有效支持。需要进行纵向研究以了解多次自杀未遂情况下持续照料的影响。
启示
护士可以为照料者提供早期支持和信息以及长期的心理社会干预。如果照料者得到充分的装备和支持，患者的安全和福祉将得到改善。
影响
这项系统回顾的结果包括由于照料者过度警惕导致关系变化，从而降低自主性并生活在自杀可能性之中。临床医生意识到关系转变的可能性将有助于他们为照料者做好准备并提供支持。
患者或公众贡献
没有患者或公众的贡献。
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