异基因造血干细胞移植幸存者的生存经历：一项定性系统综述

Survivorship Experiences of Allogeneic Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Systematic Review.

作者信息

Ruan Jiayin, Cheng Huilin, Liu Qi, Xu Fen, Kwok Wilson Yeung Yuk, Luo Dan, Qian Ying, Cheung Denise Shuk Ting, Li Hangting, Yeung Wing Fai

机构信息

Author Affiliations: School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region (Mss Ruan and Liu, Drs Cheng and Yeung, and Mr Kwok); Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (Ms Xu); School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu (Dr Luo); Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang (Ms Qian); School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region (Dr Cheung); and Hematology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang (Ms Li), People's Republic of China.

出版信息

Cancer Nurs. 2024 Jul 16. doi: 10.1097/NCC.0000000000001383.

DOI:10.1097/NCC.0000000000001383

PMID:39016254

Abstract

BACKGROUND

The number of allogeneic hematopoietic stem cell transplantation (allo-HSCT) survivors is increasing globally. Although qualitative studies in this population are reported, clear understanding of how allo-HSCT survivors experience survivorship is lacking.

OBJECTIVE

This study aimed to identify, appraise, and synthesize evidence from qualitative research on survivorship experience among allo-HSCT survivors.

METHODS

A qualitative systematic review was conducted. A literature search of 9 databases and OpenGrey, Google Scholar, and Google was performed from inception to February 2023. Two reviewers independently screened and assessed the eligibility of each study. Descriptive information was extracted from the studies by one reviewer and checked by another. Findings were extracted and analyzed using thematic synthesis.

RESULTS

Seventeen articles were included. Four themes and 12 subthemes regarding allo-HSCT survivors' experiences emerged: (1) recovery as being a longer process than they thought (influenced by long-term physical symptoms, disturbed by survivorship uncertainty); (2) experiencing a restricted survivorship life (shrunken social world, forced dietary limitations, centered around hospitals); (3) suffering from stigma and discrimination (perceived as a burden, seen differently by others, difficulties establishing and maintaining romantic relationships and marriage, limited opportunities in work); and (4) realizing something positive obtained during survivorship (enriched survivorship self-management skills, enhanced personal growth, developed positive relationships).

CONCLUSIONS

The findings reveal the challenges, needs, and growth that allo-HSCT survivors experienced during survivorship. Some understudied areas were identified, which warrant further exploration.

IMPLICATIONS FOR PRACTICE

Targeted survivor-centered care should be provided to allo-HSCT survivors, and interventions to resolve issues experienced during survivorship should be developed.

摘要

背景

全球范围内，异基因造血干细胞移植（allo-HSCT）幸存者的数量正在增加。尽管有关于这一人群的定性研究报道，但对于allo-HSCT幸存者如何体验生存过程仍缺乏清晰的认识。

目的

本研究旨在识别、评估和综合来自定性研究的关于allo-HSCT幸存者生存经历的证据。

方法

进行了一项定性系统评价。从数据库建立至2023年2月，对9个数据库以及OpenGrey、谷歌学术和谷歌进行了文献检索。两名评审员独立筛选并评估每项研究的 eligibility。由一名评审员从研究中提取描述性信息，并由另一名评审员进行核对。使用主题综合法提取并分析研究结果。

结果

纳入了17篇文章。出现了4个关于allo-HSCT幸存者经历的主题和12个子主题：（1）康复过程比他们想象得更长（受长期身体症状影响，因生存不确定性而困扰）；（2）经历受限的生存生活（社交圈子缩小、饮食受限、以医院为中心）；（3）遭受耻辱和歧视（被视为负担、他人看法不同、建立和维持恋爱关系及婚姻困难、工作机会有限）；（4）意识到在生存过程中获得了一些积极的东西（丰富了生存自我管理技能、个人成长得到提升、建立了积极的人际关系）。