中华护理杂志 ›› 2022, Vol. 57 ›› Issue (12): 1440-1446.DOI: 10.3761/j.issn.0254-1769.2022.12.005
吴尧(), 谢碧姣, 王丹心, 林晓丽, 谭绍英, 李慧妍, 王涛()
收稿日期:
2021-08-31
出版日期:
2022-06-20
发布日期:
2022-06-13
通讯作者:
王涛,E-mail: 642759213@qq.com作者简介:
吴尧:女,本科(硕士在读),护士,E-mail: 814324973@qq.com
基金资助:
WU Yao(), XIE Bijiao, WANG Danxin, LIN Xiaoli, TAN Shaoying, LI Huiyan, WANG Tao()
Received:
2021-08-31
Online:
2022-06-20
Published:
2022-06-13
摘要:
目的 系统评价康复期脑卒中患者跌倒风险预测模型,以期为临床实践提供参考依据。 方法 系统检索中国知网、万方数据知识服务平台、PubMed、Cochrane和Embase数据库截至2021年6月发表的康复期脑卒中患者跌倒风险预测模型相关文献,语种限定为中文和英文。由2名研究者独立筛选文献和提取数据,对纳入研究的人群特征、研究类型、预测因素、模型构建方法及模型预测结果等进行分析和比较。 结果 共纳入12项研究,包含15个模型,其中10个模型报告了模型的曲线下面积,有4个模型同时报告了曲线下面积的可信区间,4个模型表现出良好的区分度。仅有6个模型进行了拟合优度检验,其中4个模型报告了P值,结果显示一致性良好。12项研究的适用性较好,但存在较高的偏倚风险,主要是因为分析领域的应变量事件数不足、忽略缺失数据、基于单变量分析筛选预测因子、缺乏模型性能评估以及模型过度拟合。 结论 康复期脑卒中患者跌倒风险预测模型尚存在一些不足,未来研究应完善研究设计和研究报告,并进行内部验证和外部验证。
吴尧, 谢碧姣, 王丹心, 林晓丽, 谭绍英, 李慧妍, 王涛. 康复期脑卒中患者跌倒风险预测模型的系统评价[J]. 中华护理杂志, 2022, 57(12): 1440-1446.
WU Yao, XIE Bijiao, WANG Danxin, LIN Xiaoli, TAN Shaoying, LI Huiyan, WANG Tao. Systematic evaluation of a fall risk prediction model in convalescent stroke patients[J]. Chinese Journal of Nursing, 2022, 57(12): 1440-1446.
[1] | 蔡憐环, 庞书勤, 王宝莲, 等. 脑卒中患者康复促进因素的研究[J]. 中华护理杂志, 2017, 52(7):785-788. |
Cai LH, Pang SQ, Wang BL, et al. A study on the experienc of rehabilitation promoting factors in stroke patients[J]. Chin J Nurs, 2017, 52(7):785-788. | |
[2] | 柳清霞, 郭红, 徐小菁, 等. 脑卒中患者跌倒恐惧心理的研究进展[J]. 护理学杂志, 2017, 32(1):18-21. |
Liu QX, Guo H, Xu XJ, et al. Fear of falls in patients with stroke:a literature review[J]. J Nurs Sci, 2017, 32(1):18-21. | |
[3] | Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2016, 47(6):E98-E169. |
[4] | Haddad YK, Bergen G, Florence CS. Estimating the economic burden related to older adult Falls by state[J]. J Public Health Manag Pract, 2019, 25(2):E17-E24. |
[5] | 韩斌如, 张聪雅. 老年脑卒中患者护理依赖现状调查[J]. 中华护理杂志, 2019, 54(5):672-677. |
Han BR, Zhang CY. The level of care dependency in elderly stroke patients[J]. J Nurs Sci, 2019, 54(5):672-677. | |
[6] | Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community[J]. Cochrane Database Syst Rev, 2012, 2012(9):D7146. |
[7] | 李莺, 程云, 赵丽蓉, 等. 奥塔戈运动对老年脑卒中患者害怕跌倒的影响[J]. 中华护理杂志, 2014, 49(12):1442-1447. |
Li Y, Cheng Y, Zhao LR, et al. Effect of Otago exercise programme on fear of falling in elderly patients with stroke[J]. J Nurs Sci, 2014, 49(12):1442-1447. | |
[8] | 林哲欣, 陈妙虹, 路明霞, 等. 广东省36家医院跌倒护理质量现状调研分析[J]. 全科护理, 2017, 15(6):751-753. |
Lin ZX, Chen MH, Lu MX, et al. Investigation and analysis on the quality of fall nursing in 36 hospitals in Guangdong Province[J]. Chin General Pract Nurs, 2017, 15(6):751-753. | |
[9] | 宋玲玲, 谭美银, 梁倩婷, 等. MORSE跌倒评估量表结合跌倒因子评估在预防脑卒中患者跌倒中的应用[J]. 齐鲁护理杂志, 2020, 26(1):74-77. |
Song LL, Tan MY, Liang QT, et al. Application of MORSE Fall Evaluation Scale combined with fall factor evaluation in preventing falls in stroke patients[J]. J Qilu Nurs, 2020, 26(1):74-77. | |
[10] | 许剑蕾, 廖阳. Morse跌倒评估量表预测与脑卒中康复期患者跌倒的相关性研究[J]. 护理与康复, 2020, 19(6):52-54. |
Xu JL, Liao Y. Study on the relationship between the prediction of Morse Fall Evaluation Scale and falls in convalescent patients with cerebral apoplexy[J]. Nurs Rehabil J, 2020, 19(6):52-54. | |
[11] |
Himmelreich JCL, Veelers L, Lucassen WAM, et al. Prediction models for atrial fibrillation applicable in the community:a systematic review and meta-analysis[J]. Europace, 2020, 22(5):684-694.
DOI PMID |
[12] |
Wolff RF, Moons K, Riley RD, et al. PROBAST:a tool to assess the risk of bias and applicability of prediction model studies[J]. Ann Intern Med, 2019, 170(1):51-58.
DOI URL |
[13] |
Lee KB, Lee JS, Jeon IP, et al. An analysis of fall incidence rate and risk factors in an inpatient rehabilitation unit:a retrospective study[J]. Top Stroke Rehabil, 2021, 28(2):81-87.
DOI URL |
[14] |
Yoshimoto Y, Tanaka M, Sakamoto A. Effective combined assessments of weight bearing ratio and Four Square Step Test in predicting falls in discharged stroke patients[J]. J Stroke Cerebrovasc Dis, 2021, 30(3):105582.
DOI URL |
[15] | Wei TS, Liu PT, Chang LW, et al. Gait asymmetry,ankle spasticity,and depression as independent predictors of falls in ambulatory stroke patients[J]. PLoS One, 2017, 12(5):E177136. |
[16] |
Lee HH, Jung SH. Prediction of post-stroke falls by quantitative assessment of balance[J]. Ann Rehabil Med, 2017, 41(3):339-346.
DOI URL |
[17] |
Pinto EB, Nascimento C, Monteiro M, et al. Proposal for a new predictive scale for recurrent risk of fall in a cohort of community-dwelling patients with stroke[J]. J Stroke Cerebrovasc Dis, 2016, 25(11):2619-2626.
DOI URL |
[18] |
Baetens T, De Kegel A, Calders P, et al. Prediction of falling among stroke patients in rehabilitation[J]. J Rehabil Med, 2011, 43(10):876-883.
DOI PMID |
[19] |
Nakagawa Y, Sannomiya K, Kinoshita M, et al. Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan[J]. Environ Health Prev Med, 2008, 13(3):138-147.
DOI URL |
[20] |
Ashburn A, Hyndman D, Pickering R, et al. Predicting people with stroke at risk of falls[J]. Age Ageing, 2008, 37(3):270-276.
DOI PMID |
[21] |
Wada N, Sohmiya M, Shimizu T, et al. Clinical analysis of risk factors for falls in home-living stroke patients using functional evaluation tools[J]. Arch Phys Med Rehabil, 2007, 88(12):1601-1605.
DOI URL |
[22] |
Mackintosh SF, Hill KD, Dodd KJ, et al. Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation[J]. Arch Phys Med Rehabil, 2006, 87(12):1583-1589.
DOI URL |
[23] |
Sze KH, Wong E, Leung HY, et al. Falls among chinese stroke patients during rehabilitation[J]. Arch Phys Med Rehabil, 2001, 82(9):1219-1225.
DOI URL |
[24] |
Nyberg L, Gustafson Y. Fall prediction index for patients in stroke rehabilitation[J]. Stroke, 1997, 28(4):716-721.
PMID |
[25] |
Mayo NE, Korner-Bitensky N, Becker R, et al. Predicting falls among patients in a rehabilitation hospital[J]. Am J Phys Med Rehabil, 1989, 68(3):139-146.
DOI URL |
[26] | 许汝福. Logistic回归变量筛选及回归方法选择实例分析[J]. 中国循证医学杂志, 2016, 16(11):1360-1364. |
Xu RF. Selection for independent variables and regression method in logistic regression:an example analysis[J]. Chin J Evid-Based Med, 2016, 16(11):1360-1364. | |
[27] | Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD):the TRIPOD statement[J]. BMJ, 2015, 350(131):211-219. |
[28] |
Wong J, Taljaard M, Forster AJ, et al. Addition of time-dependent covariates to a survival model significantly improved predictions for daily risk of hospital death[J]. J Eval Clin Pract, 2013, 19(2):351-357.
DOI URL |
[29] | 吴伟, 肖灵君, 林彩娜, 等. 四方格移步测试(中文版)评定脑卒中患者平衡能力的信效度研究[J]. 中国康复医学杂志, 2021, 36(6):664-669. |
Wu W, Xiao LJ, Lin CN, et al. Reliability and validity of Chinese version of the Four Square Step Test for assessing balance function in patients with stroke[J]. Chin J Rehabil Med, 2021, 36(6):664-669. |
[1] | 吴月红, 梁红霞, 席芳, 李成, 李莹莹, 贾育萌, 郑云云, 冯珍珍. 体外膈肌起搏预防无创机械通气患者膈肌功能障碍的效果研究[J]. 中华护理杂志, 2022, 57(9): 1029-1034. |
[2] | 王子安, 刘欣, 张茜, 俞梦盈, 郑贝贝, 陆骏, 陈婷婷. 经皮冠状动脉介入治疗术后患者恐动症水平变化轨迹研究[J]. 中华护理杂志, 2022, 57(9): 1035-1041. |
[3] | 邓雁, 余琼, 武福姣, 方亮. 基于自我效能理论的护理干预对食管癌根治术后患者的影响[J]. 中华护理杂志, 2022, 57(9): 1042-1047. |
[4] | 成磊, 钱佳艺, 段明霞, 黄海英, 王颖雯. 专业照护者感知的癌症患儿向成人过渡影响因素的质性研究[J]. 中华护理杂志, 2022, 57(9): 1048-1053. |
[5] | 孙艳霞, 李莹, 刘明月, 郭丹丹, 李敏. 宫颈癌患者性健康护理培训方案的构建[J]. 中华护理杂志, 2022, 57(9): 1054-1060. |
[6] | 胡丽莎, 彭红华, 米元元, 曹咪, 胡敏, 祝玲, 喻红君, 彭淑华. 肿瘤靶向治疗患者皮肤不良反应预防及管理的证据总结[J]. 中华护理杂志, 2022, 57(9): 1061-1069. |
[7] | 孙倩倩, 叶红芳, 杨莉. 接纳与承诺疗法对乳腺癌患者干预效果的Meta分析[J]. 中华护理杂志, 2022, 57(9): 1070-1078. |
[8] | 李静, 侯云霞, 强万敏. 癌症患者非计划性再入院风险预测模型的范围综述[J]. 中华护理杂志, 2022, 57(9): 1079-1087. |
[9] | 孟祥敏, 王倩, 闫荣, 林雨婷, 丁敏. 结直肠癌患者报告结局评估工具及临床应用的研究进展[J]. 中华护理杂志, 2022, 57(9): 1094-1099. |
[10] | 周红琴, 陈秀萍, 诸纪华, 夏姗姗, 金陈娣, 盛美君, 罗飞翔, 谢王芳, 左泽兰, 胡静, 刘丽丽, 浦凯. 儿科ICU护士对每日唤醒患儿的知信行现状调查[J]. 中华护理杂志, 2022, 57(9): 1100-1104. |
[11] | 蒋琪霞, 唐永利, 洪艳燕, 匡丹, 王静, 展颖颖, 潘迎春, 高艳红, 郝景平, 陈锐, 刘海燕, 俞萍, 蔡蕴敏, 黄玲, 王祖晶. 50所医院老年患者皮肤损伤现状及危险因素分析[J]. 中华护理杂志, 2022, 57(9): 1105-1112. |
[12] | 贾红红, 刘丽, 罗小茜, 周郁秋. 认知-预警干预对农村糖尿病治疗延误患者的效果研究[J]. 中华护理杂志, 2022, 57(9): 1113-1119. |
[13] | 张毅, 汪健健, 邓艳红, 陈章群, 罗姜, 彭德珍, 赵丽萍. 护士人文素养自评量表的研制及信效度检验[J]. 中华护理杂志, 2022, 57(9): 1120-1128. |
[14] | 吴海燕, 王淑芹, 郭琪, 张春艳, 贾燕瑞, 孙兵. 1例肾病综合征合并肺孢子菌及巨细胞病毒肺炎患者的护理[J]. 中华护理杂志, 2022, 57(9): 1129-1133. |
[15] | 张晓梅, 秦毅, 陈瑜, 王伶俐, 李静逸, 王娅. 经中心静脉通路装置采血的最佳证据总结[J]. 中华护理杂志, 2022, 57(9): 1134-1140. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||