痴呆患者进食困难管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2021.09.021

摘要/Abstract

摘要：

目的评价并总结痴呆患者进食困难管理相关证据,旨在为医护人员和有关决策者提供参考。方法系统检索国内外数据库中痴呆患者进食困难管理相关文献,包括临床决策、指南、专家共识、推荐实践、证据总结、系统评价/Meta分析,检索时限为2016年1月—2020年12月,由研究者根据相关文献评价标准进行评价并提取证据。结果共纳入17篇文献,包括1篇临床决策、3篇指南、3篇专家共识、1篇推荐实践、1篇证据总结、8篇系统评价,从组织规范、培训教育、实践3个方面总结出40条证据。结论痴呆患者进食困难管理证据涉及范围较广,内容丰富,科学、有效的管理措施可以减少患者进食困难的发生。证据使用者在证据转化过程中应考虑具体情境,分析证据与临床实践的差距,有针对性地选择证据,以便制订符合个体情况的本土化的痴呆患者进食困难管理方案,改善其营养状况,提升照护质量。

关键词: 痴呆, 进食困难, 证据总结, 循证护理学

Abstract:

Objective To evaluate and summarize the evidence related to feeding difficulty in people with dementia for health care workers and decision makers. Methods All evidence on management of feeding difficulty in people with dementia was retrieved from domestic and foreign databases from January 2016 to December 2020,including clinical decisions,guidelines,expert consensuses,recommended practices,evidence summaries and systematic reviews. The researchers evaluated and collected the evidence according to relevant literature evaluation criteria. Results A total of 17 articles were included in this study,including 1 clinical decision,3 guidelines,3 expert consensuses,1 recommended practice,1 evidence summary,and 8 systematic reviews. A total of 40 pieces of best evidence were summarized from 3 aspects of organization policy,education,and practice. Conclusion Evidence involves a wide range and rich contents,and scientific and effective management measures can reduce the occurrence of feeding difficulty. In the process of clinical transformation of evidence,we should carefully select evidence,analyze the gap between evidence and clinical practice,and construct an evidence-based practice plan for feeding difficulty in people with dementia.

Key words: Dementia, Feeding Difficulty, Evidence Summary, Evidence-Based Nursing

徐霓影, 任昕燕, 王茜茜, 沈睿, 盖家兴, 王俊杰. 痴呆患者进食困难管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(9): 1401-1407.

XU Niying, REN Xinyan, WANG Xixi, SHEN Rui, GAI Jiaxing, WANG Junjie. Evidence summary of management of feeding difficulty in people with dementia[J]. Chinese Journal of Nursing, 2021, 56(9): 1401-1407.

图/表 4

表1 纳入文献的一般特征

Table 1 Characteristics of included studies

表2 指南质量评价结果

Table 2 Quality evaluation of guidelines

表3 痴呆患者进食困难管理的证据总结

Table 3 Evidence summary of management of feeding difficulty in people with dementia

表3 续痴呆患者进食困难管理的证据总结

Table 3 Continued Evidence summary of management of feeding difficulty in people with dementia

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