张国艳　叶娟　王柯鑫　焦桃芳　李利

Qualitative study on the authentic experience of cardiac rehabilitation after heart valve replacement：a Meta－integration

ZHANG Guoyan，YE Juan，WANG Kexin，JIAO Taofang，LI LiSchool of Nursing，Southwest Medical University，Sichuan 646000 ChinaCorresponding Author LI Li，E－mail：2671923313@qq.com

Abstract Objective：Meta integrates the authentic experience of cardiac rehabilitation in patients undergoing heart valve replacement surgery.Method：PubMed，Web of Science，PsychINFO，CINAHL，EMbase，the Cochrane Library，JBI Evidence based Health Care Center in Australia，CNKI，VIP，WanFang Database，CBM，Yiigle，and other databases were systematically searched.The search deadline was from database establishment to December 30，2022.The 2016 version of the Quality Evaluation Standards for Qualitative Research by the Australian JBI Evidence Based Healthcare Center was adopted for quality evaluation，and the research results were analyzed and organized in depth through aggregation and integration.Result：A total of 10 articles were included，29 research results were extracted，8 categories were summarized，and three integrated results were formed：challenge and dilemma，effort and growth，hope and craving.Conclusion：There are many physical and mental difficulties that affect the rehabilitation process in patients after heart valve replacement surgery.It is suggested that medical staff should pay attention to the postoperative rehabilitation experience of such patients，provide professional，targeted，all－round，and sustainable cardiac rehabilitation plans for patients，and advocate for the construction of a good social support system to help patients actively recover.

Keywords heart valve replacement;cardiac rehabilitation;experience;qualitative research;Meta－integration

摘要 目的：Meta整合心臟瓣膜置换术后病人心脏康复的真实性体验。方法：系统检索PubMed、Web of Science、PsycINFO、CINAHL、EMbase、the Cochrane Library、澳大利亚Joanna Briggs Institute（JBI）循证卫生保健中心、中国知网（CNKI）、维普数据库（VIP）、万方数据库（WanFang Database）、中国生物医学文献数据库（CBM）、中华医学期刊全文数据库（Yiigle）等，检索时限为建库至2022年12月30日。采用澳大利亚JBI循证卫生保健中心2016版质性研究质量评价标准进行质量评价，之后通过汇集性整合的方式对研究结果进行深入分析整理。结果：共纳入文献10篇，提炼了29个研究结果，归纳了8个类别，综合形成了3个整合结果：挑战与困局、努力与成长、希望与渴求。结论：心脏瓣膜置换术后病人存在诸多身心困扰影响康复进程，提示医护人员应重视该类病人术后康复体验，为病人提供专业化、针对性、全方位、可持续的心脏康复方案，并倡导构建良好社会支持体系，帮助病人积极康复。

关键词 心脏瓣膜置换术；心脏康复；体验；质性研究；Meta整合

doi：10.12102/j.issn.2095－8668.2024.02.004

心脏瓣膜病（heart valve disease，HVD）是由多种原因引起的心脏瓣膜狭窄和（或）反流所致的心脏疾病，是心脏外科常见的多发病［1］。心脏瓣膜置换术是治疗心脏瓣膜病的最佳方式，为提高病人术后生存质量，改善疾病预后，早期心脏康复将是治疗关键［2－3］。心脏康复是指由多学科团队围绕药物、运动、营养、心理、危险因素管理五大处方，综合制定的全病程康复方案，包括Ⅰ期、Ⅱ期、Ⅲ期3个分期［4－5］。有研究显示，心脏康复参与者全因死亡率降低了53％，心脏相关死亡率下降了57％［6］，而瓣膜病病人亦能从心脏康复中获益。……