Deni Yasmara, MN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
Sin-Hang Tam, MSN, RN, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Wound Ostomy Continence Nurs. 2024;51(1):19-25. doi: 10.1097/WON.0000000000001046.
The aim of this scoping literature review was to identify current knowledge related to management of malignant fungating wounds (MFWs), gaps in this knowledge, and areas for future research.
This was a scoping literature review.
Six electronic databases (Embase, MEDLINE, Cochrane (CENTRAL), CINAHL, Scopus, and Web of Science) were searched spanning the years 1987 and 2022. The initial electronic database search retrieved 6041 studies. The search is based on 60 articles published between 1987 and 2022, along with 14 additional studies were based on search of reference lists of key articles.
Studies were divided into 2 main domains; the vast majority (65 of 72, 87.8%) focused on symptom impact, measurement, and management. The remaining articles (n = 9, 12.2%) focused on caring for patients with MFW; these studies focused on nursing care experiences and competencies, along with lay caregiver experiences. Findings indicated that instruments have been developed to evaluate symptoms of MFW but only a few have been validated. Most of the studies reviewed evaluated the influence of MFW on physical and psychosocial function. Local and systematic symptom managements such as modern dressings, wound care strategies, surgery, and radiotherapy as well as chemotherapy were found to be effective in alleviating symptoms. Findings also indicated that families and nurses encounter obstacles and burdens when caring for patients with MFW; limited studies were retrieved that investigated the competence and needs of nurses in their caring journey.
Future studies should focus on: (1) using better designs to evaluate and compare topical agents and dressings to control odor, (2) validating assessment tools specific to MFW, (3) qualitative studies designed to enhance understanding family and nurses' experiences, and (4) improving the nurse's ability to care for patients with MFWs and their responses to managing these challenging patients.
本范围文献综述旨在确定与恶性肿瘤性溃疡（MFW）管理相关的现有知识、知识空白以及未来研究方向。
本研究为范围文献综述。
共检索了 6 个电子数据库（Embase、MEDLINE、Cochrane（CENTRAL）、CINAHL、Scopus 和 Web of Science），时间跨度为 1987 年至 2022 年。最初的电子数据库检索共获得了 6041 项研究。该检索基于 1987 年至 2022 年期间发表的 60 篇文章，以及对关键文章参考文献列表的搜索额外获得了 14 篇文章。
研究分为 2 个主要领域；绝大多数（72 项研究中的 65 项，占 87.8%）侧重于症状影响、测量和管理。其余 9 项（占 12.2%）研究则侧重于护理 MFW 患者；这些研究侧重于护理经验和能力，以及非专业护理人员的经验。研究结果表明，已经开发了一些工具来评估 MFW 的症状，但只有少数工具得到了验证。大多数已综述的研究评估了 MFW 对身体和社会心理功能的影响。局部和系统的症状管理，如现代敷料、伤口护理策略、手术、放疗以及化疗，都被证明可以有效缓解症状。研究结果还表明，家庭成员和护士在照顾 MFW 患者时会遇到障碍和负担；检索到的研究有限，无法调查护士在护理过程中的能力和需求。
未来的研究应重点关注：（1）使用更好的设计来评估和比较控制气味的局部制剂和敷料；（2）验证针对 MFW 的特定评估工具；（3）设计定性研究以增强对家庭和护士的体验的理解；（4）提高护士照顾 MFW 患者的能力，并对这些具有挑战性的患者的管理做出反应。
