介绍呼吸系统疾病中的一类情绪困扰模型:症状管理模型的系统评估与理论综合

Abstract Aim To undertake a theoretical systematic review to develop a conceptual model of illness‐related emotional distress in the context of symptom management in chronic respiratory disease. Design We performed a systematic search to identify conceptual models. Data sources Electronic databases MEDLINE , CINAHL , EMBASE and Psyc INFO were searched and papers included from inception of the search term until June 2017. Review methods The review was conducted following Pound and Campbell's and Turner's theory synthesis. Conceptual models were appraised using Kaplan's criteria. Models were excluded if they referred to a specific condition and/or lacked clarity. Results This synthesis, which includes five models and additional evidence, yielded a new conceptual model describing the processes of regulation and symptom self‐management in chronic respiratory disease. Identified sources of illness‐related emotional distress are new or increased symptoms, additional treatment, new restrictions in performance of daily life roles and increased unpredictability. People goals and self‐efficacy were identified as further drivers of symptom self‐management. The regulation process is embedded in contextual factors. Conclusion Theory synthesis provided transparent guidance in developing a model to understand of the factors driving self‐management decisions. Therefore, the model has the potential to guide development of interventions that support symptom self‐management in chronic respiratory disease. Impact This newly presented conceptual model of illness‐related emotional distress provides an understanding of the factors that drive self‐management decisions when peoples experience new or increased symptoms. Such understanding is critical for nursing practice to developing appropriate interventions, especially in support of people decision‐making.