国际护理科学（英文）2026，Vol.13Issue(2)：140-148,9.DOI:10.1016/j.ijnss.2026.02.004
慢性病共病护理时间负担的概念分析
Time toxicity in chronic disease comorbidity care:A concept analysis using Walker and Avant's approach
摘要
Abstract
Objectives:This study aimed to conceptually analyze time toxicity within the context of chronic disease comorbidity,identifying its defining attributes,antecedents,and consequences to guide future nursing practice and patient-centered care strategies. Methods:This study adopted Walker and Avant's eight-step concept analysis approach,integrating thematic analysis with framework analysis.A systematic search was conducted,then,peer-reviewed literature and clinical guidelines were included and the defining attributes,antecedents,conse-quences,and empirical referents of time toxicity were extracted.Qualitative data were analyzed using NVivo 12,employing iterative coding and categorization.The summary themes were structured into a three-tiered conceptual framework.The conceptual boundaries were rigorously refined through the examination of exemplar,borderline,and contrary cases. Results:A total of 35 articles were included.This study identified seven key defining attributes of time toxicity in chronic disease comorbidities:psychological burden,burden of chronic disease management,caregiver burden,medication burden,time burden,economic burden,and healthcare inequities.The antecedents of time toxicity include changes in patient conditions,deficiencies in support systems,and inefficiencies within the healthcare system,all of which interact to exacerbate its effects.The conse-quences for patients include declines in quality of life,impaired self-management,and deteriorating mental health,alongside increased healthcare utilization costs.Chronic disease comorbidity time toxicity can be defined as the increasingly severe,multifaceted burdens faced by patients managing multiple chronic diseases. Conclusions:Time toxicity is a multidimensional construct significantly affecting patients with chronic disease comorbidity.Recognizing and addressing it is vital for improving health outcomes.Nurses and care coordinators are uniquely positioned to implement time-conscious,personalized interventions.关键词
慢性病管理/概念分析/共病/护理/生活质量/时间负担/治疗负担Key words
Chronic disease management/Concept analysis/Multimorbidity/Nursing/Quality of life/Time toxicity/Treatment burden引用本文复制引用
宋平,袁素娥,关玉珠,陈宇珈,马海静,李云霞..慢性病共病护理时间负担的概念分析[J].国际护理科学（英文）,2026,13(2):140-148,9.基金项目
This work was funded by the National Natural Science Foun-dation of China(Grant No.72504117).The funder had no role in the study design,the collection,analysis,or interpretation of data,the writing of the report,or the decision to submit the article for publication. （Grant No.72504117）
