背景:CAR-T疗法已成为诊断为血液系统恶性肿瘤的个体的潜在有效治疗方法。了解患者对这种治疗方法的独特体验至关重要。这些知识将有助于开发量身定制的护理干预措施,以满足以患者为中心的护理日益重要的要求。
目的:研究和综合患者及其家庭照顾者在治疗过程中的经历的定性数据。
方法:我们进行了系统综述和定性荟萃综合。符合条件的研究包含成年患者或家庭护理人员关于CAR-T疗法经验的报价,自2015年以来,在同行评审期刊上以英文或中文发表。数据源包括MEDLINE、CINAHL,Embase,PsycINFO,WebofScience,Scopus,科克伦图书馆,CNKI,和万方。
方法:系统搜索产生6373篇鉴定文章。其中,分析中包括12份报告,涵盖了11项独立研究。两个审阅者独立地将数据提取到NVIVO12.0中。通过全文逐行编码进行定性元合成,将代码组织成描述性主题,和发展主题。
结果:定性荟萃合成产生了八个主要主题。患者及其家庭护理人员关于CAR-T治疗旅程的值得注意的启示涵盖了各个方面。在CAR-T治疗之前,患者缺乏实际选择,与对治疗结果的期望作斗争,遇到复杂的情感体验。在CAR-T治疗期间或之后立即,患者报告了舒适和不舒服的经历。此外,患者强调,对治疗疗效和不良反应的担忧加剧了治疗相关的痛苦.CAR-T治疗后,观察到显著的变化,以及家庭康复的负担。此外,我们发现,CAR-T治疗费用较高的原因是因素.
结论:为了确保CAR-T疗法的安全性和可持续性,这是至关重要的,以解决患者的身体和心理方面的经验。有效的沟通和全面的管理受到患者及其护理人员的高度重视。进一步的研究应探索减轻负担的方法,并为患者及其家人制定自我管理教育计划。
BACKGROUND: CAR-T therapy has emerged as a potentially effective treatment for individuals diagnosed with hematologic malignancies. Understanding patients\' unique experiences with this therapeutic approach is essential. This knowledge will enable the development of tailored nursing interventions that align with the increasing importance of patient-centered care.
OBJECTIVE: To examine and synthesize qualitative data on patients and their family caregivers\' experiences during the treatment journey.
METHODS: We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained adult patient or family caregiver quotes about experiences of CAR-T therapy, published in English or Chinese in a peer-reviewed journal since 2015. Data sources included MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Scopus, Cochrane Library, CNKI, and WanFang.
METHODS: Systematic search yielded 6373 identified articles. Of these, 12 reports were included in the analysis, which covered 11 separate studies. Two reviewers independently extracted data into NVIVO 12.0. Qualitative meta-synthesis was performed through line-by-line coding of full text, organization of codes into descriptive themes, and development themes.
RESULTS: The qualitative meta-synthesis yielded eight primary themes. Noteworthy revelations from patients and their family caregivers regarding the CAR-T therapy journey encompassed various aspects. Prior to CAR-T therapy, patients experienced a lack of actual choice, struggled with expectations for treatment outcomes, and encountered intricate emotional experiences. During or immediately after CAR-T therapy, patients reported both comfortable and uncomfortable experiences. Additionally, patients emphasized that concerns regarding treatment efficacy and adverse reactions intensified treatment-related distress. After CAR-T therapy, significant changes were observed, and the burden of home-based rehabilitation. Additionally, we found factors contributed to the high CAR-T therapy cost.
CONCLUSIONS: To ensure the safety and sustainability of CAR-T therapy, it is crucial to address the physical and psychological aspects of the patient\'s experience. Effective communication and comprehensive management are highly valued by patients and their caregivers. Further research should investigate ways to reduce burdens and develop self-management education programs for patients and their families.