脊髓损伤患者居家康复体验质性研究的Meta整合

doi:10.3761/j.issn.1672-9234.2025.04.015

摘要/Abstract

摘要：

目的整合脊髓损伤患者居家康复体验的质性研究，帮助医护人员及利益相关者了解脊髓损伤患者居家康复的体验。方法检索PubMed、Web of Science、Embase、CINAHL、The Cochrane Library、PsycINFO、中国知网、万方、维普数据库，检索时限为建库至2025年1月。2名研究者分别独立筛选文献并提取资料，采用汇集性整合方法分析资料。结果共纳入11篇文献，提炼出50个结果，归纳为12个类别和4个整合结果：感受到动力，居家康复信心不断提升；出院后原有生活发生改变，感知到障碍因素和挑战；体会到疾病威胁，采取不同应对策略；感觉支持未满足，渴望获得更多的帮助。结论脊髓损伤患者居家康复的体验受到多重因素影响，医护人员应不断帮助患者应对居家康复中遇到的障碍与挑战，以提高患者的居家护理质量。

关键词: 脊髓损伤, 居家康复, 体验, 质性研究, Meta整合

Abstract:

Objective To integrate qualitative research on the home rehabilitation experiences of spinal cord injury patients and to help healthcare professionals and stakeholders better understand these experiences.Methods PubMed，Web of Science，Embase，CINAHL，The Cochrane Library，PsycINFO，CNKI，Wanfang Database，VIP Database were searched from database inception to January 2025. Each of the 2 researchers independently screened the literature and extracted information，which was collected and analyzed using a pooled integration approach.Results A total of 11 papers were included，and 50 outcomes were distilled into 12 categories and four integrative outcomes：1）feeling motivated and increasing confidence in home rehabilitation；2）changes in the original life after discharge and perceived obstacle factors and challenges；3）experiencing the threat of the disease and adopting different coping strategies；and 4）perceived unmet support needs and desire for additional assistance.Conclusion The home rehabilitation experiences of patients with spinal cord injury are influenced by a variety of factors，and healthcare professionals should continue to help patients address the barriers and challenges encountered during home rehabilitation in order to improve the quality of home care.

Key words: Spinal cord injury, Home rehabilitation, Experience, Qualitative research, Meta-synthesis

卢楠, 苟晓瑜, 李梦洁, 于万慧, 迟嘉婧, 杨丽娟, 杨滕, 闫路瑶, 李雯. 脊髓损伤患者居家康复体验质性研究的Meta整合[J]. 中华护理教育, 2025, 22(4): 471-477.

LU Nan, GOU Xiaoyu, LI Mengjie, YU Wanhui, CHI Jiajing, YANG Lijuan, YANG Teng, YAN Luyao, LI Wen. Home rehabilitation experiences of patients with spinal cord injuries：a qualitative meta-synthesis[J]. Chinese Journal of Nursing Education, 2025, 22(4): 471-477.

图/表 4

参考文献 20

[1]	Xiang L, Li H, Xie QQ, et al. Rehabilitation care of patients with neurogenic bladder after spinal cord injury:a literature review[J]. World J Clin Cases, 2023, 11(1):57-64. doi: 10.12998/wjcc.v11.i1.57 pmid: 36687186
[2]	Huang HY, Young W, Skaper S, et al. Clinical neurorestorative therapeutic guidelines for spinal cord injury(IANR/CANR version 2019)[J]. J Orthop Translat, 2020, 20:14-24. doi: 10.1016/j.jot.2019.10.006
[3]	葛小霞, 史文莉. 基于康复助手APP的延续性健康管理在偏远地区老年脑卒中患者出院后居家康复中的应用[J]. 护士进修杂志, 2023, 38(23):2138-2142.
[4]	Ruediger M, Kupfer M, Leiby BE. Decreasing re-hospitalizations and emergency department visits in persons with recent spinal cord injuries using a specialized medical home[J]. J Spinal Cord Med, 2021, 44(2):221-228. doi: 10.1080/10790268.2019.1671075
[5]	高馨, 李伦兰, 戴晴, 等. 脊髓损伤患者居家康复体验的质性研究[J]. 中华护理杂志, 2021, 56(11):1691-1697. doi: 10.3761/j.issn.0254-1769.2021.11.015
	Gao X, Li LL, Dai Q, et al. Home rehabilitation experience for individuals with spinal cord injury:a qualitative study[J]. Chin J Nurs, 2021, 56(11):1691-1697. doi: 10.3761/j.issn.0254-1769.2021.11.015
[6]	JBI. JBI critical appraisal checklist for qualitative research[EB/OL].[2024-08-13]. http://joannabriggs.org/assets/docs/critical-appraisal-tools.html.
[7]	Lockwood C, Munn Z, Porritt K. Qualitative research synthesis:methodological guidance for systematic reviewers utilizing meta-aggregation[J]. Int J Evid Based Healthc, 2015, 13(3):179-187.
[8]	Baniya M, Rana C, Dhakal R, et al. The experience of limited access to care for community-based patients with spinal cord injury and stroke in Nepal and the potential of telerehabilita-tion:a qualitative study[J]. Inquiry, 2023, 60:469580221146830.
[9]	戴晴, 李伦兰, 高馨, 等. 脊髓损伤患者对居家康复环境因素体验的质性研究[J]. 护理学杂志, 2023, 38(10):13-17.
[10]	Moran K, Barclay L, Lannin NA. Experiences of people with non-traumatic spinal cord injuries returning home after inpa-tient rehabilitation[J]. Disabil Rehabil, 2024, 46(2):362-368.
[11]	高柏, 石薇琢, 黎玉辉. 康复期脊髓损伤患者心理体验及调适现状的质性研究[J]. 中文科技期刊数据库(引文版)医药卫生, 2022(9):288-291.
[12]	van Diemen T, van Nes IJW, et al. Learning self-care skills after spinal cord injury:a qualitative study[J]. BMC Psychol, 2021, 9(1):155. doi: 10.1186/s40359-021-00659-7 pmid: 34627397
[13]	Weber L, Voldsgaard NH, Holm NJ, et al. Exploring the con-textual transition from spinal cord injury rehabilitation to the home environment:a qualitative study[J]. Spinal Cord, 2021, 59 (3):336-346. doi: 10.1038/s41393-020-00608-y pmid: 33564119
[14]	Bernet M, Sommerhalder K, Mischke C, et al. “Theory does not get you from bed to wheelchair”:a qualitative study on patients’ views of an education program in spinal cord injury rehabilitation[J]. Rehabil Nurs, 2019, 44(5):247-253.
[15]	Bourke JA, Hay-Smith EJC, Snell DL, et al. Attending to biog-raphical disruption:the experience of rehabilitation following tetraplegia due to spinal cord injury[J]. Disabil Rehabil, 2015, 37(4):296-303. doi: 10.3109/09638288.2014.918188 pmid: 24828314
[16]	Jannings W, Pryor J. The experiences and needs of persons with spinal cord injury who can walk[J]. Disabil Rehabil, 2012, 34(21):1820-1826. doi: 10.3109/09638288.2012.665126 pmid: 22423597
[17]	Dickson A, Ward R, O’Brien G, et al. Difficulties adjusting to post-discharge life following a spinal cord injury:an interpre-tative phenomenological analysis[J]. Psychol Health Med, 2011, 16(4):463-474. doi: 10.1080/13548506.2011.555769 pmid: 21749243
[18]	Guinan EM, Doyle SL, O’Neill L, et al. Effects of a multimo-dal rehabilitation programme on inflammation and oxidative stress in oesophageal cancer survivors:the ReStOre feasibility study[J]. Support Care Cancer, 2017, 25(3):749-756. doi: 10.1007/s00520-016-3455-0 pmid: 27807666
[19]	Chang FH, Liu CH, Hung HP. An in-depth understanding of the impact of the environment on participation among people with spinal cord injury[J]. Disabil Rehabil, 2018, 40(18):2192-2199.
[20]	曲瑞杰, 李豪, 程秋泓, 等. 慢性阻塞性肺疾病患者参与肺康复体验质性研究的Meta整合[J]. 中华护理教育, 2022, 19(06):548-554.
	Qu RJ, Li H, Cheng QH, et al. Experience of participating in the pulmonary rehabilitation in patients with chronic obstru-ctive pulmonary disease:a qualitative meta-synthesis[J]. Chin J Nurs Educ, 2022, 19(06):548-554.