老年人跌倒预防临床实践指南的质量评价及内容分析

doi:10.3761/j.issn.0254-1769.2019.11.027

摘要/Abstract

摘要：

目的对国内外老年人跌倒预防临床实践指南进行质量评价和内容分析,为构建适合中国的老年人跌倒预防临床实践指南提供参考。方法计算机检索美国国立实践技术指南库、国际指南协作网、英国国家卫生与临床优化研究所指南网、苏格兰校际指南网、加拿大安大略注册护士协会、澳大利亚Joanna Briggs Institute（JBI）循证卫生保健中心,以及PubMed、Embase、CINAHL、中国知网、万方数据库、中国生物医学文摘数据库中涉及老年人跌倒预防的相关指南。采用临床实践指南评价工具对纳入指南进行质量评价,并对指南的内容进行分析。结果共纳入13篇临床实践指南,其中2篇为A级推荐、9篇为B级推荐、2篇为C级推荐。临床实践指南评价工具6个领域的平均得分分别为范围和目的96.01%、清晰性81.34%、参与人员64.24%、严谨性51.60%、应用性51.28%、独立性44.44%。经内容分析,最终得出7个方面27项与跌倒预防相关的内容。结论目前国内外跌倒预防临床实践指南的总体质量不佳,指南在制定的严谨性、应用性和编辑独立性方面均有待提高,老年人跌倒预防临床实践指南的内容宽泛,有待进一步完善。

关键词: 老年人, 跌倒预防, 实践指南, 内容分析法, 循证护理学

Abstract:

Objective To evaluate the quality and analyze content of existing clinical practice guidelines related to fall prevention in the elderly,and to provide reference for developing clinical practice guidelines suitable for domestic health care settings.Methods National Guideline Clearinghouse（NGC）,Guidelines International Network（GIN）,National Institute for Health and Clinical Excellence（NICE）,Scottish Intercollegiate Guidelines Network（SIGN）,Registered Nurses Association of Ontario（RNAO）,Joanna Briggs Institute（JBI）,PubMed,Embase,CINAHL,CNKI,Wanfang,and CBM were searched to collect clinical practice guidelines related to fall prevention. Guidelines meeting inclusion criteria were evaluated using AGREE II instrument and content was analyzed.Results A total of 13 clinical practice guidelines were included,2 were grade A recommendation,9 were grade B recommendation and 2 were grade C recommendation. The 6 domains with highest scores were scope and purpose（96.01%）,clarity（81.34%）,participants（64.24%）,eligibility（51.60%）,applicability（51.28%）,independence（44.44%）. Finally 7 themes including 27 items were extracted by content analysis.Conclusion Overall,the quality of existing clinical practice guidelines related to fall prevention in the elderly is not good that should be improved in eligibility,applicabilty and editorial independence,the contents of the guidelines are extensive but need to be further improved.

Key words: Aged, Fall Prevention, Practice Guideline, Content Analysis, Evidence-Based Nursing

王玉梅, 李凌, 熊莉娟, 袁金蓉, 夏漫, 刘艾红, 田媛, 李佳, 李鑫. 老年人跌倒预防临床实践指南的质量评价及内容分析[J]. 中华护理杂志, 2019, 54(11): 1729-1734.

WANG Yumei, LI Ling, XIONG Lijuan, YUAN Jinrong, XIA Man, LIU Aihong, TIAN Yuan, Li Jia, LI Xin. Quality evaluation and content analysis of existing clinical practice guidelines related to fall prevention in the elderly[J]. Chinese Journal of Nursing, 2019, 54(11): 1729-1734.

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