#护理SCI文献分享: 《Journal of Clinical Nursing》:皮肤病、性行为和亲密关系

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今天给老师们分享一篇源自《Journal of Clinical Nursing》的文献:Barisone M; Bagnasco A; Hayter M; et al. Dermatological diseases, sexuality and intimate relationships: A qualitative meta-synthesis[J]. Journal of Clinical Nursing, 2020,29(17-18):3136-3153.

 #本文研究问题

要了解一篇文章,小编认为首先要明确文章的研究问题,如本文中的研究问题是探讨皮肤病患者性行为和亲密关系的定性研究中的关键主题是什么(What are the key themes within the qualitative research literature exploring sexuality and intimate relationship experiences of people living with dermatological disease?)?

 #以下是本文的摘要:

Aims and objectives: To conduct a systematic review and meta-synthesis of findings from qualitative research about sexuality and intimate relationship among patients with dermatological diseases.

研究目的:对有关皮肤病患者性行为和亲密关系的定性研究结果进行系统评价和meta-整合。

Background: Over the last few decades, there has been an increase in clinical research investigating aspects related to sex and sexuality in patients living with dermatological diseases. In fact, studies recognise a negative impact on various aspects of intimacy, such as sexual function, self-esteem and romantic relationships. The body of qualitative literature about sexuality in the context of dermatological diseases is emerging but consists mainly of small studies that would benefit from aggregation, synthesis and interpretation to highlight and summarise the overarching dimensions to this clinical issue.

研究背景:在过去的几十年中,有关皮肤病患者性和性行为方面的临床研究有所增加。研究显示,皮肤病对亲密关系的各个方面产生负面影响,例如性功能,自尊和浪漫关系。关于皮肤病性行为的定性文献正在兴起,但主要由小型研究组成。汇总、整合和解释这些研究可帮助了解该临床问题的总体方面。

Design: A systematic review and meta-synthesis of qualitative studies.

研究设计:定性研究的系统评价和meta-整合。

Methods: BioMed Central, Cochrane Library, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, ERIC, Scopus, and Web of Science were searched between June–November 2017 with no publication date limits. Screening and selection of studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). After retrieval, the qualitative data were subject to meta-synthesis to identify overarching themes.

研究方法:在2017年6月至11月之间,检索BioMed Central,Cochrane图书馆,MEDLINE,CINAHL,PsycINFO,PsycARTICLES,ERIC,Scopus和Web of Science。根据PRISMA进行文献的筛选和选择。检索后,对定性数据进行meta整合以识别总体主题。

Results: Ten qualitative studies were found. We identified four themes: (a) Embarrassment and shame; (b) Impaired sense of attractiveness and sexual avoidance; (c) Relationship issues; and (d) Lack of professional support. The patients in these studies adopted negative coping styles, such as avoidance and hiding their

bodies.

研究结果:共纳入十项定性研究。确定了四个主题:(a)尴尬和羞耻;(b)吸引力感觉受损和性回避;(c)关系问题; (d)缺乏专业支持。在这些研究中,患者采取了消极的应对方式,例如回避和掩饰自己的身体。

Conclusion: When assessing and evaluating patient care in dermatology, it is important that sexuality and the impact the disease could have on relationships is included.

研究结论:在评估和评价皮肤科患者的护理时,必须将性行为和疾病可能对人际关系产生的影响纳入其中。

 #本文中值得与大家分享的一些点:

1. 文章报告依据:Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines

2. 关于检索策略:作者根据“PEO (Population, Exposure, Outcome)”来制定检索策略,其中,Population,即研究人群,指皮肤疾病相关的条目(skin disease-related terms); Exposure,暴露因素,指性行为相关的条目(sexuality-related terms); Outcome,研究结果,指患者经历,这里使用了定性研究相关的条目(qualitative research-related terms)。具体使用的关键词如下表所示:

3. 关于纳入与排除标准:在纳入标准中,作者对语言、研究对象的年龄进行了限定,纳入了有关性行为和亲密关系的原始定性研究,不仅纳入了关于皮肤病患者经历的文章,同时还纳入了报告患者伴侣观点的研究(这一点可能会被忽略);此外,作者排除了专门从事医疗保健的专业人员作为参与者的文章(其实小编对这一点是持质疑态度的,为什么要排除呢,如果非医疗保健专业人员患者与医疗保健专业人员患者的结果有差异,不是更能说明相关医疗知识的重要作用吗……当然可能还涉及很多其他因素,大家也可以讨论一下)。

4. 关于灰色文献的查询:作者采用了以下方法检索灰色文献:检索纳入研究的参考文献、检索Biomed以获得会议记录或摘要、检索Google Scholar以获取未被编入索引的文章、检索WorldCat数据库以查询相关学位论文。

5. 关于质量评价:研究团队采用CASP(the Critical Appraisal Skills Programme)进行文献质量评价,将CASP中的10个指导性问题分成了30个条目来评估研究的质量;此外,根据Williams、Boylan和Nunan的研究评估了关于可转移性、可信度、反射性和透明度(Transferability, Credibility, Reflexivity, Transparency)等定性研究特征的偏差风险。感兴趣的老师们推荐大家阅读Williams等人的文章:Williams V, Boylan A, Nunan D. Critical appraisal of qualitative research: necessity, partialities and the issue of bias[J]. BMJ Evidence-Based Medicine, 2020,25:9-11.

好啦,今天就先到这里,欢迎大家一起讨论,也欢迎大家对以上内容指正(boxueduocai@aliyun.com),我们下期见~

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