老年性痴呆病人医院外环境改进管理指南的系统综述  

Systematic review of guidelines for improving the management of environment outside hospital among patients with Alzheimer’s disease

作　　者：刘柔韧 杨柳[1] 康艳楠 李珂 韩广荭 高维杰[1] 靳英辉 LIU Rouren;YANG Liu;KANG Yannan;LI Ke;Han Guanghong;GAO Weijie;JIN Yinghui(School of Nursing,Tianjin University of Traditional Chinese Medicine,Tianjin 301600 China)

机构地区：[1]天津中医药大学护理学院,301600 [2]武汉大学中南医院循证与转化医学中心,430000

出　　处：《护理研究》2019年第17期2913-2922,共10页Chinese Nursing Research

基　　金：国家自然科学基金青年项目，编号：81603496

摘　　要：[目的]检索和评价通过环境管理促进老年性痴呆病人安全的相关循证指南,为更好地保障老年性痴呆病人的生理安全、降低其精神行为问题发生率提供参考。[方法]计算机检索国内外指南网站、医学会网站和综合指南数据库,纳入促进老年性痴呆病人安全的环境相关改进管理循证指南,检索时限均为建库至2017年2月。采用指南评价工具AGREEⅡ对纳入的指南进行质量评价,汇总各指南的推荐意见比较其异同。[结果]检索到老年性痴呆循证指南若干部,最终纳入7部相关指南均来自国外,7部指南AGREEⅡ评价各维度平均得分为:范围和目的74.60%、参与人员55.56%、严谨性44.49%、清晰性73.02%、应用性36.01%和独立性37.50%,指南总体质量评价均为B级。共提取到48条可用推荐意见。各指南推荐的环境改进管理措施主要涉及降低其精神行为问题发生风险和降低其生理性伤害发生风险两大属性。[结论]纳入指南总体质量一般,完善指南的严谨性、应用性和独立性领域后会更适用。老年性痴呆病人环境改进管理的方法较广泛,但因其证据支持不够全面,研究者们应继续进行高质量的研究,并及时制定具有我国特色的环境改进管理相关指南及评价,以支持临床的循证转化。Objective:To search and evaluate the related evidence . based guidelines for promoting the safety of Alzheimer's disease patients through environmental improvement. Further more,to provide reference for better protecting the physiological safety of Alzheimer's disease patients and reducing the incidence of mental behavior problems. Methods:By retrieving from the domestic and international guideline websites,the medical association websites and the comprehensive guideline databases,the relevant evidence .based guidelines for improving environment . related management to promote Alzheimer patients' safety were included from databases establishment to February 2017. Each guideline was evaluated by using AGREEⅡ and the recommendations of each guideline were summarized in order to compare their similarities and differences. Results:Seven relevant evidence .based guidelines for Alzheimer's disease were included, which all were from abroad. According to the AGREEⅡevaluation ,the average scores of six dimensions were 74. 60% for the scope and purpose,55. 56% for the participants,44. 49% for the rigor,73. 02% for the clarity,36. 01% for the applicability,and 37. 50% for the independence. The overall quality assessment of the guidelines was at grade B. A total of 48 recommendations were available for this study,which were mainly involved in reducing the risk of mental behavior problems and the risk of physiological injuries. Conclusions: The overall quality of included guidelines was general. More efforts were needed to improve the rigor,applicability and independence of guidelines. The management methods of environmental improvement for Alzheimer's disease patients were extensive. However,there were still no enough evidence supports concerning the methods safety of improving Alzheimer's disease patients’external environment in China. It was suggested that more high.quality studies should be conducted,and the relevant management guidelines and evaluations of environmental improvement that were more suitable for Chine

关 键 词：老年性痴呆 病人安全 护理管理 环境管理 指南 系统综述 护理安全 

分 类 号：R197.323[医药卫生—卫生事业管理]