维持性血液透析患者参与血管通路决策体验质性研究的Meta整合OA

Objective To systematically synthesize the experience,challenges,and needs of patients receiving maintenance hemodial-ysis(MHD)during vascular access decision-making process.Methods A systematic search for qualitative studies on experience of MHD patients regarding vascular access decision-making was conducted in databases including China National Knowledge Infrastruc-ture(CNKI),VIP Database,Wanfang Data,China Biomedical Literature Service System,Chinese Medical Journal Full-text Database,PubMed,Web of Science,Cochrane Library,Embase,CINAHL,PsycINFO,and Scopus,with a retrieval period spanning from database inception to November 30,2025.Results Nine studies were collected.The findings were categorized into nine groups and synthe-sized into three integrated findings:Multiple dilemmas in vascular access decision-making;Core considerations in vascular access de-cision-making;Key elements of and expectations for support in vascular access decision-making.Conclusion Patients face multi-ple challenges in vascular access decision-making.Their decision-making is centered on life value and highly dependent on trust rela-tionship and social support.Clinicians should establish individualized,dynamic communication and support models that respect patient preferences to enhance decision quality.