以质量求发展，以服务铸品牌

护理学报 ›› 2020, Vol. 27 ›› Issue (24): 31-37.doi: 10.16460/j.issn1008-9969.2020.24.031

• 循证护理 • 上一篇    下一篇

全髋关节置换患者疼痛评估循证指南质量评价

赵存1, 王兴蕾1,2, 韩春彦1, 裴菊红1, 张亚斌1, 苟玲1, 豆欣蔓1,2   

  1. 1.兰州大学 护理学院,甘肃 兰州 730000;
    2.兰州大学第二医院,甘肃 兰州 730000
  • 收稿日期:2020-08-21 出版日期:2020-12-25 发布日期:2021-01-15
  • 通讯作者: 豆欣蔓（1979-）,女,甘肃兰州人,博士,主任护师,护理部主任。E-mail：douxm@lzu.edu.cn
  • 作者简介:赵存（1993-）,女,河北保定人,本科学历,硕士研究生在读。
  • 基金资助:
    2018年甘肃省陇原青年创新创业人才（团队）项目（2018-7）

Quality Evaluation of Evidence-based Guidelines for Pain Assessment in Patients with Total Hip Arthroplasty

ZHAO Cun1, WANG Xing-lei1,2, HAN Chun-yan1, PEI Ju-hong1, ZHANG Ya-bin1, GOU Ling1, DOU Xin-man1,2   

  1. 1. School of Nursing, Lanzhou University, Lanzhou 730000, China;
    2. The Second Hospital of Lanzhou University, Lanzhou 730000, China
  • Received:2020-08-21 Online:2020-12-25 Published:2021-01-15

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摘要： 目的 系统检索国内外关于全髋关节置换疼痛评估临床实践指南,为临床制定全髋关节置换患者疼痛评估护理实践方案提供依据。方法 计算机检索专业学会、指南网站及数据库,检索时限为建库至2019年12月。严格按照纳入排除标准筛选指南,应用AGREE II评价工具进行质量评价,并汇总高质量指南的推荐意见。结果 共纳入8部指南,其中英文指南7部,国内指南1部。8部指南AGREE II 6个领域中平均得分由高到低依次是范围和目的89.35%、表达清晰性82.18%、参与人员81.02%、编辑独立性80.90%、应用性68.56%、严谨性65.54%。指南质量评价结果为5部A级指南,3部B级指南。本研究对8部指南推荐意见进行汇总,共得出28条推荐意见。推荐意见内容包括评价人员、评价工具、评价时机、评价内容、镇痛效果评估。结论 全髋关节置换疼痛评估指南总体质量较好,部分指南需在应用性、严谨性领域进一步改善。我国全髋关节置换疼痛评估指南仅有1部,现阶段可考虑将国内外高质量指南本土化后在我国临床实施,作为指导临床疼痛评估的标准,以缓解患者疼痛,改善生活质量,提高护理服务质量。

关键词: 髋关节置换, 临床实践指南, AGREE II, 质量评价

Abstract: Objective To systematically search clinical practice guidelines for pain assessment of patients with total hip replacement (THR) at home and abroad and to provide reference for nursing program of pain assessment for patients with THR. Methods Guidelines meeting the inclusion and exclusion criteria from professional societies, guide websites and databases were collected from the inception to December 2019. AGREE II evaluation tool was used for quality evaluation, and the recommendations of high-quality guidelines were summed up. Results A total of 8 guidelines were included, with 7 in English and 1 in Chinese. Of the 8 guidelines, six fields in AGREE II with average score ranking from high to low were range and purpose (89.35%), clarity of expression (82.18%), participants (81.02%), editorial independence (80.90%), applicability (68.56%), and rigorousness (65.54%). After overall quality evaluation of the guidelines, 5 A-level and 3 B-level guides were identified. After summarizing the recommendations of the 8 guidelines, 28 recommendations are obtained covering evaluation staff, tools, timing, and content, and analgesic effect evaluation. Conclusion There is only one pain assessment guideline for THR in Chinese. After localization, high-quality foreign guidelines abroad can be considered as a guideline for clinical pain assessment for Chinese patients, thus to alleviate pain, improve patients’ quality of life, and nursing quality.

Key words: total hip arthroplasty, clinical practice guideline, AGREE II, guideline evaluation

中图分类号: 

  • R473.6
[1] 吴仕军,秦雪丽.地佐辛复合舒芬太尼用于全髋关节置换患者术后镇痛效果观察[J].中外女性健康研究,2017(5):40-42.DOI:10.3969/j.issn.2096-0417.2017.05.023.
[2] 丁英茹,赵枫,吕辉照,等.全髋关节置换术后不同镇痛方式有效性与疼痛敏感度的关系[J].中华关节外科杂志(电子版),2017,11(3):250-254.DOI:10.3877/cma.j.issn.1674-134X.2017.03.007.
[3] 杨秀娥,郑蓉婷,池清华.基于JCI标准的疼痛管理机制的建立与效果研究[J].中国卫生标准管理,2019,10(9):163-165.DOI:10.3969/j.issn.1674-9316.2019.09.066.
[4] 陈婷,方为民.骨科医护人员疼痛管理认知的现状调查[J].护理学杂志,2019, 34(15):59-61.DOI:10.3870/j.issn.1001-4152.2019.15.059.
[5] 黎晓艳,童莺歌,陈佳佳,等.国外疼痛评估循证护理实践指南解读[J].护理学杂志,2017,32(16):14-17.DOI:10.3870/j.issn.1001-4152.2017.16.014.
[6] 梁莉娟,卢蕊,高姣.540例骨科创伤患者疼痛性失眠及疼痛控制态度调查分析[J].西南国防医药,2019,29(10):1034-1036.DOI:10.3969/j.issn.1004-0188.2019.10.013.
[7] 褚雪玲,刘少群,何婉珠,等.ADL评估联合临床护理路径在减轻经皮椎体成形术后疼痛的应用[J].广东医科大学学报,2019,37(2):221-223.DOI:10.3969/j.issn.1005-4057.2019.02.032.
[8] 贺育华,杨婕,蒋理立.对外科护士基于计划行为理论的疼痛管理行为干预效果[J].护理学报,2018,25(23):5-9.DOI:10.16460/j.issn1008-9969.2018.23.005.
[9] 王玲玲,李培利,霍宁.持续改进护理评估流程对妇科护理质量敏感性指标的影响研究[J].首都食品与医药,2019,26(11):83.DOI:10.3969/j.issn.1005-8257.2019.11.064.
[10] 贾玉娥,高儒,朱雪琴,等.持续改进护理评估流程对妇科护理质量敏感性指标的影响[J].临床护理杂志,2017,16(3):63-66.DOI:10.3969/j.issn.1671-8933.2017.03.026.
[11] 戴新娟,翟晓萍,张文杰,等.中医护理评估流程和质量标准的构建[J].中华护理杂志, 2012, 47(7):658-659.DOI:10.3761/j.issn.0254-1769.2012.07.030.
[12] Grilli R, Magrini N, Penna A, et a1. Practice Guidelines Developed by Specialty Societies: The Need for a Critical Appraisal[J].Lancet,2000,355(9198):103-106.DOI:10.1016/S0140-6736(99)02171-6.
[13] Brouwers MC, Kho ME, Browman GP, et al.AGREE Ⅱ:Advancing Guideline Development, Reporting, and Evaluation in Health Care[J].Prev Med,2010,51(5):421-424.DOI:10.1016/j.ypmed.2010.08.005.
[14] 韦当,王聪尧,肖晓娟,等.指南研究与评价(AGREE Ⅱ)工具实例解读[J].中国循证儿科杂志,2013,8(4):316-319.DOI:10.3969/j.issn.1673-5501.2013.04.017.
[15] Irajpour A, Hashemi M, Taleghani F.The Quality of Guidelines on the End-of-life Care: A Systematic Quality Appraisal Using AGREE Ⅱ Instrument[J].Support Care Cancer,2020,28(4):1555-1561.DOI:10.1007/s00520-019-05220-2.
[16] Zhang J, Xu J, Zhang W, et al.Quality Appraisal of Guidelines on Cancer-associated Thrombosis Using AGREE II Instrument and Analysis of Current Status of New Oral Anticoagulants[J].Clin Appl Thromb Hemost,2019(25):1076029619846562. DOI:10.1177/1076029619846562.
[17] 戴琪,丁亚萍,余洁,等.1型糖尿病病人运动管理干预最佳证据总结[J].护理研究,2019,33(20):3563-3567.DOI:10.12102/j.issn.1009-6493.2019.20.023.
[18] 崔立军,鲍勇,陈昕,等.中国康复临床实践指南的质量评价[J].中国循证医学杂志,2019,19(6):723-728.DOI:10.7507/1672-2531.201806079.
[19] 李江,唐威,李霓,等.乳腺癌筛查指南方法学质量和报告质量的系统评价[J].中国循证医学杂志, 2018, 18(6):629-636.DOI:10.7507/1672-2531.201803081.
[20] Barr J, Fraser G,Puntillo K.Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit[J].Crit Care Med,2013,41(1):263-306.DOI:10.1097/CCM.0b013e3182783b72.
[21] Scottish Intercollegiate Guideline Network(SIGN). A National Clinical Guideline: Management of Hip Fracture in Older People2009[R/OL].(2016-06-01)[2019-12-01].https://www.sign.ac.uk/sign-111-management-of-hip-fracture-in-older-people.html.
[22] Brenda DR,Anastasia HR,Monique LR.Assessment and Management of Pain[M]. 3rd ed. Toronto:Registered Nurses’ Association of Ontario,2013:1-105.
[23] Keelan E, Marcie HH, Douglas MW, et al.Non-arthritic Hip Joint Pain:Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association[J]. J Orthop Sports Phys Ther, 2014,44(6):A1-A32.
[24] Michael TC, Nancy JB, Keelan RE, et al. Hip Pain and Mobility Deficits—hip Osteoarthritis: Revision2017 Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association[J]. J Orthop Sports Phys Ther, 2017,47(6):A1-A 37.
[25] National Institute Health and Care Excellence(NICE). NICE Guideline-major Trauma: Assessment and Initial Management2016[R/OL].(2016-02-17)[2019-12-01].https:www. nice.org.uk/guidance/ng39.
[26] Scottish Intercollegiate Guideline Network(SIGN).A National Clinical Guideline: Management of Chronic Pain2019[R/OL].(2019-08-01)[2019-12-01]. https://www.sign.ac.uk/sign-136-management-of-chronic- pain.html.
[27] 邱贵兴,裴福兴,唐佩福,等.骨科常见疼痛管理临床实践指南(2018版)[J].中华骨与关节外科杂志,2019,12(3):161-167.DOI:10.3969/j.issn.2095-9958.2019.03.001.
[28] 王晋芳,徐杨,陈延亭,等.顺产产妇会阴损伤预防与修复循证指南的质量评价[J].中华护理杂志,2018, 53(2):162-168.DOI:10.3761/j.issn.0254-1769.2018.02.007.
[29] 陈振,程宏涛.半髋关节置换术与全髋关节置换术对老年股骨颈骨折患者预后的影响[J]. 临床医学研究与实践,2019, 35(4):66-67.DOI:10.19347/j.cnki.2096-1413.201935027.
[30] 黄琴. 全髋关节置换术与人工股骨头置换术治疗骨质疏松性股骨颈骨折的疗效对比[J].基层医学论坛,2019,23(35):5065-5066.DOI:10.19435/j.1672-1721.2019.35.024.
[31] Burgers JS, Grol R, Klazinga NS, et al.Towards Evidence-based Clinical Practice:An International Survey of 18 Clinical Guideline Programs[J].Int J Qual Health Care,2003,15(1):31-45.DOI:10.1093/intqhc/15.1.31.
[32] Alonso-Coello P, Martínez García L, Carrasco JM, et al.The Updating of Clinical Practice Guidelines: Insights from an International Survey[J]. Implement Sci,2011,13(6):107.DOI:10.1186/1748-5908-6-107.
[33] 周奇,王小琴,姚亮,等.临床实践指南更新的若干关键问题[J].中国循证儿科杂志,2016,11(5):392-397.DOI:10.3969/j.issn.1673-5501.2016.05.016.
[34] National Institute for Clinical Excellence: The guidelines manual London: NICE, 2009[R/OL].(2009-09-01)[2019-12-01].https://www.nice.org.uk/sharedlearning/can-we-improve-the-implementation-of-the-nice-guidelines-for-depression-and-the-anxiety-disorders-in-southwark.
[35] World Health Organization. WHO Handbook for Guideline Development.2012[R/OL].[2019-12-01].https://apps.who.int/iris/bitstream/handle/10665/145714/9789241548960_eng.pdf.
[36] 王晋芳. 顺产产妇会阴损伤预防与修复循证实践方案的构建[D].北京:北京中医药大学,2018.
[37] 陈耀龙,王小琴,吴琼芳,等.中国临床实践指南更新情况调查[J].中国循证医学杂志, 2014, 14(2):178-183.DOI:10.7507/1672-2531.20140032.
[38] 陈耀龙,杨克虎,田金徽,等.循证实践指南的制定:国际经验与中国实践[J].兰州大学学报(医学版),2016,42(1):29-35.
[39] Lugtenberg M, van Beurden KM, Brouwers EP, et al. Occupational Physicians’ Perceived Barriers and Suggested Solutions to Improve Adherence to a Guideline on Mental Health Problems: Analysis of a Peer Group Training[J]. BMC Health Serv Res,2016,16:271-281.DOI:10.1186/s12913-016-1530-3.
[40] Joosen MCW, van Beurden KM, Rebergen DS, et al. Effectiveness of a Tailored Implementation Strategy to Improve Adherence to a Guideline on Mental Health Problems in Occupational Health Care[J].BMC Health Serv Res, 2019,19(1):281-294. DOI:10.1186/s12913-019-4058-5.
[41] Stander J, Grimmer K, Brink Y.Factors Influencing Clinical Practice Guideline Uptake by South African Physiotherapists: A Qualitative Investigation of Barriers and Facilitators[J]. J Eval Clin Pract, 2019.DOI:10.1111/jep.13182.DOI10.1111/jep.13182.
[42] 陈耀龙,杨克虎.正确理解、制订和使用临床实践指南[J].协和医学杂志,2018,9(4):367-373.DOI:10.3969/j.issn.1674-9081.2018.04.015.
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