Abstract:

Objective To explore the research content,theoretical framework,adaptation process,the quality of the methodology and reporting of adaptation of guidelines in the nursing field in China. Methods The literature on the theme of the guidelines adaptation in clinical practice in China was systematically searched from PubMed,Cochrane Library,CINAHL,EMBASE,Scopus,Web of Science,CNKI,Wanfang,VIP database. 2 reviewers independently screened the literature,extracted the data and assessed the quality of the adaptation of guidelines by AGREEⅡ tool and RIGHT statement. Results A total of 23 studies were included. 69.6% of the studies were published in the last 3 years,and only 7 (30.4%) of the studies reported the funding support. In terms of research themes,65.2% of the studies focused on the care of diseases and their symptoms,and only 12 (52.2%) reported the methods used in the process of adaptation,among which 7 (30.4%) used ADAPTE methods. Methodological quality evaluation results showed that the area with an average score of more than 60% out of the 6 areas included scope and purpose,participants,and clarity of expression. The area with the lowest score was editorial independence. According to the quality evaluation results of the report,the areas with an average score of >4 among the 7 areas include basic information,background and recommendation,and the lowest score is funding and conflict of interest declaration and management. Conclusion The number of studies on adaptation of guidelines in the nursing field in China is increasing obviously,but the theoretical framework based on the adaptation of guidelines and the quality of the methodology and reporting of the adaptation guidelines are poor.

Key words: Guideline Adaptation, Guideline Integration, ADAPTE, AGREEⅡ, RIGHT, Scoping Review, Evidence-Based Nursing

摘要：

目的 探讨我国临床护理实践指南改编研究的内容、理论框架、改编过程、方法学质量及报告质量。 方法 系统检索PubMed、Cochrane Library、CINAHL、Embase、Scopus、Web of Science、中国知网、万方、维普、中国生物医学文献数据库、医脉通等数据库中以我国护理领域指南改编为主题的文献,检索时限为建库至2021年4月20日,由2名研究者独立筛选、提取数据,采用描述性分析对数据进行合成,采用临床指南研究与评价系统Ⅱ (appraisal of gui-delines for research and evaluationⅡ,AGREE Ⅱ) 工具和临床实践指南报告标准 (reporting items for practice guidelines in healthcare,RIGHT) 对指南的方法学质量和报告质量进行评价。 结果 共纳入23篇文献,16篇 (69.6%) 文献发表于近3年,仅7篇 (30.4%) 文献报告了基金支持。研究主题方面,15篇 (65.2%) 文献的主题为疾病及其症状的护理,仅12篇 (52.2%) 文献报告了改编过程中使用的方法,其中7篇 (30.4%) 文献采用指南改编方法 (guideline adaptation,ADAPTE) 。方法学质量评价结果显示,6个领域中平均得分>60%的领域包括范围和目的、参与人员、表达明晰性,得分最低的领域是编辑独立性。报告质量评价结果显示,7个领域中平均得分>4分的领域包括基本信息、背景、推荐意见,得分最低的领域是资金资助与利益冲突声明和管理。 结论 我国临床护理实践指南改编研究数量上呈现明显增加的趋势,但改编指南所依据的理论框架与改编指南方法学质量和报告质量欠佳。

关键词: 指南改编, 指南整合, 指南改编方法, 临床指南研究与评价系统Ⅱ, 临床实践指南报告标准, 范围综述, 循证护理学