关键词: 痴呆, 进食问题, 指南, 质量评价

Abstract:

Objective To evaluate the quality and synthesize the recommendations of guidelines on the assessment and management of eating problems among dementia patients. Methods Guidelines involving recommendations of assessment and management of eating problems among dementia patients were searched in guideline networks,websites of Alzheimer's Disease associations and databases from inception to December 19,2018. AGREE-II and related quality assessment tools were used to evaluate the quality of the guidelines. The recommendations related to the assessment and management of eating problems of dementia were synthesized. Results A total of 450 articles were initially detected,and finally 6 guidelines as well as 1 expert consensus,4 best practices,and 2 recommended practices were included. The average scores of the AGREE Ⅱ were 87.50% for the scope and purpose,61.58% for the stakeholder involvement,45.14% for the rigor of development,78.70% for the clarity of presentation,35.07% for the application,and 33.33% for the editorial independence,which were rated as Grade B. The included expert consensus,best practices,and recommended practices were from China,the United States,and Australia,respectively. Recommendations related to eating problem assessment and management involved in nutrition and eating problem assessment,adjusting the eating environment,maintaining eating autonomy,adjusting food types and delivery methods,caregiver support,dysphagia coping measures,nutritional supplements,and enteral nutrition. Conclusion The guidelines are of moderate quality,and the applicability,independence and rigor of the guidelines need to be improved. The recommendations are scattered in different guidelines and lack targeted responses to specific eating problems,and some recommendations are still controversial.

Key words: Dementia, Eating Problems, Guidebooks, Quality Appraisal