Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-04-24 Cooperative journals: 《中国全科医学》
Abstract： Background The incidence rate of stroke is high and the risk of recurrence is substantial. Most stroke patients need to transition to home after treatment，and the experience during this period is complex. Therefore，there is an urgent need to comprehensively understand experiences and feelings of patients during hospital to home transition through Meta#2;integration. Objective To systematically evaluate qualitative studies on stroke patients' hospital to home transition experiences. Methods A computerized search was undertaken for qualitative studies on the hospital to home transition experience of stroke patients in the PubMed，Web of Science，Scopus，Embase，CINAHL，PsycINFO，CNKI，and Wanfang Databases from inception to July 11，2023. The quality of the final included literature was evaluated using the Joanna Briggs Institute （JBI） Quality Evaluation Criteria for Qualitative Research（2016），Australia，and the results were combined using a pooled integration approach. Results A total of 13 studies were included，and 46 findings were distilled and categorized into 7 categories，yielding three final integrative findings：dynamic changes in the physical and psychosocial dimensions have interactive effects；a strong need for holistic caregiving；and active coping with illness and gradual transition to a new life norm. Conclusion During the period of transition from hospital to home，stroke patients face complex physical and mental challenges as well as multi-level care needs. Healthcare providers should pay attention to the real experiences and unmet needs of stroke patients throughout the hospital to home transition，provide holistic and continuous care services，and facilitate the comprehensive physical，psychological and social transition for patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-04-24 Cooperative journals: 《中国全科医学》
Abstract： Background In the face of the serious challenges posed by the high prevalence of chronic diseases among the elderly and the coexistence of multiple chronic diseases，the health problems of community-dwelling elderly people' with multimorbidity require urgent attention. The comorbidity management model is being explored and practiced. Disease experience，as self-reported health information from patients，is expected to become a key component of the patient-centered community multimorbidity management model. Objective This study aimed to gain a deeper understanding of the real disease experience of community-dwelling elderly people with multimorbidity and provide a basis for personalized health management and supportive strategies of the group. Methods This study used purposive sampling and maximum difference sampling to select eligible interviewees from four communities under the jurisdiction of a community health service center in Zhengzhou City from August to September in 2022. Based on the principle of information saturation，20 subjects were ultimately included. Based on the research objective，literature review，and expert consultation results，the preliminary interview outline was formulated， and the final interview outline was determined after interviewing 2 patients. Semi-structured interviews were conducted with the study participants，guided by the phenomenological research methodology. Golaizzi analysis was used to analyse the data. Results Four themes and eleven sub-themes had been extracted from this study，including mainly long-standing symptomatic distress（physical dysfunction，fatigue，sleep disorders，and pain），negative psychological experiences （feelings of helplessness and worry about future life，reduced sense of social value and self-identity，and loneliness with altered social activities）， positive mindset of coexisting harmoniously with multimorbidity（being grateful for being satisfied，and positively adapting）， and aspirations in times of adversity（hoping for improvement in functioning，and seeking multi-directional social support）. Conclusion Physical dysfunction，sleep disturbances，fatigue，and pain are the most concerning health disturbances for community-dwelling elderly people with multimorbidity. The symptom management and multiple social support of the multimorbidity need to be strengthened. In the future，it is expected that multidimensional data would be used for dynamic health assessment to explore the common and individual patterns of multimorbidity，and to achieve precise management and intervention of elderly multimorbidity in the community.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-08-28 Cooperative journals: 《中国全科医学》
Abstract： Background Previous studies have found that 25%-85% of stroke patients develop post-stroke fatigue （PSF），and continuous feeling of fatigue seriously affects patients' daily life and rehabilitation process. Therefore，it is urgent to understand the psychological experience and needs of such patients. However，the results of previous single qualitative studies may not be representative. Objective To systematically review and integrate qualitative studies on the fatigue experience of patients with PSF，so as to provide a reference for the construction of management strategies for PSF patients. Methods PsycINFO，PubMed，Web of Science，CINAHL，Cochrane Library，Scopes，Joanna Briggs Institute（JBI）Evidence#2;Based Health Care database，CNKI，Wanfang，VIP，CBM were searched by computer to screen qualitative studies on fatigue experience of patients with PSF from inception to July 5，2023. JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of included literature，and Meta-synthesis was performed to integrate results. Results A total of 10 papers were included，and 22 primary outcomes were distilled，grouped into 8 categories，and synthesized into 4 integrated outcomes，including significant lack of cognition of PSF；intricate negative physical and psychological experience；differentself-regulation of PSF and multiple needs for PSF rehabilitation. Conclusion PSF patients have insufficient cognition of fatigue with significant negative physical and psychological experience. Therefore，PSF patients should be identified and screened at an early stage with strengthened fatigue education and personalized fatigue management strategies. Emphasis should also be placed on the role of community and family in the management of fatigue，so that they can work together with healthcare professionals to provide a favorable rehabilitation environment for PSF patients.
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