Liosatos Kita, Tobiano Georgia, Gillespie Brigid M
School of Nursing and Midwifery, Griffith Health, Gold Coast Campus, Queensland 4222, Australia.
NHMRC Centre for Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, QLD 4222, Australia; Gold Coast Hospital and Health Service, Queensland 4215, Australia.
Int J Nurs Stud. 2024 Sep;157:104839. doi: 10.1016/j.ijnurstu.2024.104839. Epub 2024 Jun 7.
Surgical site infections can significantly impact postoperative recovery. Patient participation, which involves patients actively engaging in wound care, has been linked to improved healing and reduced wound complications. However, there is limited synthesis of the literature that explores the patient's role and participation in the context of surgical wound care.
To explore patients' perceptions of how they participate in surgical wound care, within 30 days post-operation.
An integrative review guided by Whittemore and Knafl's methodology. This review was registered with PROSPERO (CRD42022363669).
Searches were conducted in Medline (Ovid), CINAHL (Complete), and EMBASE (Elsevier) databases in October 2023, supplemented by forward and backward citation searching.
Based on a priori eligibility criteria, two authors independently screened articles to select relevant studies. The quality of the included research articles was critically appraised using the Mixed Methods Appraisal Tool. A descriptive and thematic synthesis was used to synthesise the findings.
Of the 4701 records screened for titles and abstracts, 25 studies using qualitative, quantitative, and mixed-methods designs were included. Three key themes were identified. In theme 1, 'I am healing: how my wound shapes me and my journey,' physical symptoms, psychological factors and previous experiences significantly influenced patients' engagement in wound care. Theme 2, 'Taking charge of my healing: my active engagement in wound care' described how patient participation in surgical wound care goes beyond clinical procedures and can include the use of technology and holistic self-care. Finally, theme 3, 'Navigating the path to recovery: How others shape my experience' showed that effective communication is crucial for promoting participation, yet issues like inadequate information can leave patients unprepared for wound management.
This review highlights opportunities to personalise and prioritise a patient-oriented approach to surgical wound care. Clinicians and educators should adopt an individualised approach by tailoring patient participation based on patient factors (i.e. physical symptoms) and adopt patient-centred communication approaches. Researchers should focus on exploring approaches to self-care and technology, as these approaches may enhance patient participation in wound care.
手术部位感染会对术后恢复产生重大影响。患者参与，即患者积极参与伤口护理，与伤口愈合改善及伤口并发症减少有关。然而，探索患者在手术伤口护理背景下的作用和参与情况的文献综合研究有限。
探讨患者对术后30天内参与手术伤口护理方式的看法。
采用惠特莫尔和克纳夫方法进行的综合综述。该综述已在国际系统评价前瞻性注册库（PROSPERO，注册号：CRD42022363669）注册。
2023年10月在医学期刊数据库（Medline，Ovid平台）、护理学与健康领域数据库（CINAHL，完整版）和荷兰医学文摘数据库（EMBASE，爱思唯尔平台）进行检索，并辅以顺向和逆向引文检索。
根据预先设定的纳入标准，两位作者独立筛选文章以选择相关研究。使用混合方法评估工具对纳入研究文章的质量进行严格评估。采用描述性和主题性综合方法对研究结果进行综合分析。
在筛选标题和摘要的4701条记录中，纳入了25项采用定性、定量和混合方法设计的研究。确定了三个关键主题。在主题1“我正在愈合：伤口如何塑造我及我的康复历程”中，身体症状、心理因素和既往经历显著影响患者参与伤口护理的程度。主题2“掌控我的愈合：我积极参与伤口护理”描述了患者参与手术伤口护理如何超越临床程序，还可包括使用技术和整体自我护理。最后，主题3“探寻康复之路：他人如何塑造我的体验”表明有效沟通对促进参与至关重要，但信息不足等问题会使患者对伤口管理毫无准备。
本综述突出了个性化和优先采用以患者为导向的手术伤口护理方法的机会。临床医生和教育工作者应采取个性化方法，根据患者因素（如身体症状）调整患者参与方式，并采用以患者为中心的沟通方法。研究人员应专注于探索自我护理和技术方法，因为这些方法可能会增强患者对伤口护理的参与度。
