背景:疲劳是全球系统性红斑狼疮(SLE)最常见的症状之一,然而,它仍然评估和管理不善。缺乏对疲劳的普遍定义和标准测量可能会增加对跨文化理解的持续限制。
目的:对疲劳的心理社会文化基础的研究不足;因此,在本文中,我们进行了系统综述,以了解SLE相关性疲劳的跨文化视角.
方法:遵循PRISMA(系统评价和Meta分析的首选报告项目)系统评价指南,我们搜索了CINAHLComplete,Scopus,和PubMed数据库,用于搜索日期之前涵盖的所有已发布文章。使用引文和网络搜索扩展了搜索。使用3步过程来识别符合入选标准的文章。使用叙事合成对结果进行分析。
结果:从总共搜索的370篇文章(n=364,98.4%的科学数据库;n=6,1.6%的网络和引文搜索)中,18项(4.9%)研究符合纳入和排除标准,被纳入本综述。所有(18/18,100%)研究主要招募女性参与者,一半(9/18,50%)有横截面设计。尽管并非所有研究都报道了种族,大多数研究样本中白人种族背景占最大比例。大多数(7/18,39%)的研究是在美国进行的。使用叙事综合,基于文化护理理论(CCT)和日出推动者的领域得出的突出主题如下:与SLE相关的疲劳(1)作为疾病过程的组成部分,(2)作为个人挑战,和(3)作为心理社会维度。
结论:CCT和Leininger的日出推动者指导了这篇综述。在CCT和日出推动者的其他领域如何影响SLE相关的疲劳体验方面仍然存在差距,评估,和评价。这篇综述的结果表明,SLE相关性疲劳具有疾病,个人,和心理社会成分。因此,单纯主观评估SLE和其他疾病的疲劳可能会限制更准确的评估和管理。包括疾病,个人,社会心理指标是必要和必要的。应开发具有文化敏感性和一致性的评估以及评估模型和测量工具,以准确捕获疲劳经历。此外,由于全球移民是不可避免的,症状管理策略的进步应与以下认识相一致:疲劳具有不同文化中存在的主观和客观指标.
BACKGROUND: Fatigue is one of the most common symptoms of systemic lupus erythematosus (SLE) worldwide, yet it remains poorly assessed and managed. The lack of universal definition and standard measurement of fatigue may add to the continued limitations in its understanding across cultures.
OBJECTIVE: The psycho-sociocultural underpinnings of fatigue are understudied; therefore, in this paper, we conducted a systematic
review to understand a transcultural perspective of SLE-related fatigue.
METHODS: Following PRISMA (Preferred Reporting items for Systematic Reviews and Meta-Analysis) systematic
review guidelines, we searched CINAHL Complete, Scopus, and PubMed databases for all published articles covered until the search date. Search was expanded using citation and web search. A 3-step process was used to identify articles meeting the inclusion criteria. The results were analyzed using narrative synthesis.
RESULTS: From a total of 370 (n=364, 98.4% scientific databases; n=6, 1.6% web and citation search) articles searched, 18 (4.9%) studies met the inclusion and exclusion criteria and were included in this
review. All (18/18, 100%) studies enrolled primarily female participants, and half (9/18, 50%) had cross-sectional designs. Although race was not reported in all studies, most studies had White racial background as the largest proportion of their samples. A majority (7/18, 39%) of the studies were conducted in the United States. Using a narrative synthesis, the prominent themes drawn based on the domains of the culture care theory (CCT) and the sunrise enabler were as follows: SLE-related fatigue (1) as an integral component of the disease process, (2) as a personal challenge, and (3) as a psychosocial dimension.
CONCLUSIONS: CCT and sunrise enabler by Leininger guided this
review. There are still gaps on how other domains of the CCT and sunrise enabler might influence SLE-related fatigue experience, assessment, and evaluation. The findings from this
review showed that SLE-related fatigue has disease, personal, and psychosocial components. Thus, a purely subjective assessment of fatigue in SLE and even other conditions may limit a more accurate assessment and management. The inclusion of disease, personal, and psychosocial indicators is warranted and essential. A culturally sensitive and congruent assessment as well as evaluation models and measurement tools should be developed to capture fatigue experiences accurately. In addition, since global migration is inevitable, advancement in symptom management strategies should coincide with the understanding that fatigue has subjective and objective indicators present across cultures.