Kowalczuk Anna, Moor Fiona
Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
J Hum Nutr Diet. 2025 Apr;38(2):e70043. doi: 10.1111/jhn.70043.
Coeliac disease (CD) is an autoimmune disease affecting 1.4% of the population worldwide. The only treatment for this condition is a strict, lifelong gluten-free diet (GFD). Although the complexity of this condition is recognised, the definitive follow-up strategy and long-term management have still not been developed in the United Kingdom (UK) and Australia. This meta-synthesis aimed to explore the experiences of patients living with CD who follow the GFD in the UK and Australia.
A systematic search for primary qualitative literature related to experiences of patients with CD on a GFD and a meta-synthesis of the results were conducted. Healthcare-relevant online databases were screened: Academic Search Complete, CINAHL, MEDLINE, and Scopus, followed by reference list searching. A defined inclusion criteria were used to identify relevant studies. The data synthesis from the literature followed the thematic synthesis approach. A clear description of the methodology and peer review were applied to ensure transparency.
A total of 286 studies were screened for eligibility. Of those, six studies met the inclusion criteria. The experiences of 198 patients living with CD were analysed and reported. Five analytical themes emerged through the thematic synthesis process: acceptance and adaptation, dietary burden, cost burden, socialising, and importance of support. All themes were found to impact patients' quality of life (QoL). The overall quality of the reviewed studies was described as good.
This meta-synthesis revealed insights into the daily experiences of patients with CD in adhering to a GFD in the UK and Australia, being the first secondary qualitative study to explore this phenomenon. It highlighted the need for the development of defined strategies for patient follow-up to provide holistic care, considering the complexities of this condition and its impact on both physical and psychological domains.
乳糜泻（CD）是一种自身免疫性疾病，全球1.4%的人口受其影响。这种疾病的唯一治疗方法是严格的终身无麸质饮食（GFD）。尽管人们认识到这种疾病的复杂性，但英国和澳大利亚仍未制定出明确的随访策略和长期管理方案。这项元综合研究旨在探索在英国和澳大利亚遵循GFD饮食的CD患者的经历。
对与CD患者遵循GFD饮食的经历相关的原始定性文献进行系统检索，并对结果进行元综合分析。筛选了与医疗保健相关的在线数据库：学术搜索完整版、护理学与健康领域数据库、医学索引和Scopus，随后进行参考文献列表搜索。使用明确的纳入标准来确定相关研究。文献的数据综合采用主题综合法。对方法进行了清晰描述并进行同行评审以确保透明度。
共筛选了286项研究以确定其是否符合条件。其中，六项研究符合纳入标准。分析并报告了198例CD患者的经历。通过主题综合过程出现了五个分析主题：接受与适应、饮食负担、成本负担、社交以及支持的重要性。发现所有主题均会影响患者的生活质量（QoL）。所审查研究的总体质量被描述为良好。
这项元综合研究揭示了英国和澳大利亚CD患者坚持GFD饮食的日常经历，这是第一项探索这一现象的二次定性研究。它强调了需要制定明确的患者随访策略，以提供全面护理，同时考虑到这种疾病的复杂性及其对身体和心理领域的影响。
