乳腺癌相关淋巴水肿患者保守治疗依从性障碍因素的质性研究Meta整合OA

Objective:To systematically evaluate the qualitative study on barriers to compliance with conservative treatment in patients with breast cancer-related lymphedema(BCRL),and to provide references for the formulation of intervention strategies to enhance patients'adherence to treatment.Methods:The PubMed,EBSCO,Embase,CINAHL,SinoMed,CNKI,VIP and Wanfang databases were searched for qualitative studies on barriers to compliance with conservative treatment in BCRL patients.The search timeframe was from databases construction to Sep 2025,and the Meta-synthesis was carried out using an aggregative integration method combined with framework analysis,and the quality of integration results was assessed using Con Qual.Results:A total of 10 articles were included and 29 results were extracted.These results were summarized into 9 categories and 4 themes:(1)Individual-level factors:including lack of professional knowledge and skills,negative attitudes and limited cognition,negative psychology,and care priority bias.(2)Interpersonal level factors:including inadequate family support and inadequate social support.(3)Organizational level factors:including problems with treatment options and stretched medical resources.(4)Societal level factors:including economic policies that did not include edema treatment.Con Qual ratings for integration results were all moderate.Conclusions:BCRL patients often face multilevel barriers in conservative treatment,and these factors interact with each other to reduce treatment adherence,which in turn affects the efficacy and quality of life.Healthcare professionals need to systematically assess the barriers that may exist at each level of conservative treatment for patients,need further analysis of the mechanisms at work between the barriers and formulate multifaceted interventions by combining theories such as implementation science to promote patients to actively engage in conservative treatment.