失能老人“主动健康”影响因素的最佳证据总结

doi:10.16460/j.issn1008-9969.2024.01.058

摘要/Abstract

摘要： 目的旨在系统检索、评价和整合失能老人“主动健康”影响因素的相关证据,为提高失能老人主动健康行为能力的相关策略提供参考。方法采用“6S”证据模型,系统检索国内外中英文数据库及相关专业网站,检索时限为建库至2023年7月1日。由2名受过循证护理培训的研究者独立评价文献质量并提取证据。结果共纳入21篇文献,包括1篇系统评价、2篇类实验性研究、10篇横断面研究、3篇质性研究、5篇综述。总结了包含“生命羸弱化、照护被动化、态度消极化、人际边缘化”4个类别的32条证据。结论本研究科学、严谨且全面地总结了失能老人主动健康影响因素的最佳证据,医务、照护人员可以此证据为参考,有助于为失能老人提供个性化的医疗照护服务,提升其主动健康的意识和能力,进而改善其生活质量。

关键词: 失能老人, 主动健康, 循证护理学, 证据总结

Abstract: Objective To systematically retrieve, evaluate and integrate the evidence of influencing factors of proactive health of disabled elderly people, and provide reference for strategies to improve behavior of proactive health of disabled elderly people. Methods We searched Chinese and English databases and professional websites systematically by using “6S” evidence model. The retrieval period ranged from the inception of the databases to July 1,2023. Two researchers receiving training of evidence-based nursing independently evaluated the quality of the literature and extracted evidence. Results A total of 21 articles were collected, including 1 systematic review, 2 quasi-experimental studies, 10 cross-sectional studies, 3 qualitative studies and 5 reviews. Thirty-two pieces of evidence were summarized into four categories including life weakening, care passivity, attitude passivity, and interpersonal marginalization. Conclusion This study summarizes the best evidence for influencing factors of proactive health for disabled elderly people, which can be used as reference for medical and nursing staff to provide personalized medical care services for disabled elderly people, enhance their proactive health awareness and ability, thus to improve their quality of life.

Key words: disabled elderly people, proactive health, evidence-based nursing, evidence summary

中图分类号:

R473.59

欧洋利, 沈军, 李淼, 彭颖, 廖晓艳, 张虹, 陈黎玉. 失能老人“主动健康”影响因素的最佳证据总结[J]. 护理学报, 2024, 31(1): 58-63.

OU Yang-li, SHEN Jun, LI Miao, PENG Ying, LIAO Xiao-yan, ZHANG Hong, CHEN Li-yu. Best evidence summary for influencing factors of proactive health in disabled elderly people[J]. Journal of Nursing, 2024, 31(1): 58-63.

参考文献

[1] Luo YN, Su BB, Zheng XY.Trends and challenges for population and health during population aging - China,2015-2050[J]. China CDC Wkly,2021,3(28):593-598. DOI:10.46234/ccdcw2021.158.
[2] 王慧子,王俊杰.医养结合背景下失能老人养老研究进展[J].护理研究, 2018,32(10):1495-1498. DOI:10.12102/j.issn.1009-6493.2018.10.001.
[3] 张倩倩,金花,史晓晓,等.我国主动健康的实施现状及对各责任主体实施策略的建议[J].中国全科医学,2022,25(31):3923-3927. DOI:10.12114/j.issn.1007-9572.2022.0419.
[4] 李祥臣,俞梦孙.主动健康:从理念到模式[J].体育科学, 2020,40(2):83-89. DOI:10.16469/j.css.202002009.
[5] 陈红丽,张戈,赵青,等.近10年国内护理专家共识文献质量评价与分析[J].中国护理管理,2020,20(3):399-406. DOI:10.3969/j.issn.1672-1756.2020.03.017.
[6] 周芬,郝玉芳,丛雪,等.指南研究与评价工AGREE Ⅱ及各领域分值的补充解释及思考[J].护理学报,2018,25(18):56-58. DOI:10.16460/j.issn1008-9969.2018.18.056.
[7] Foster MJ, Shurtz S.Making the Critical Appraisal for Summaries of Evidence (CASE) for evidence-based[J]. J Med Libr Assoc,2013,101(3):192-198. DOI:10.3163/1536-5050.101.3.008.
[8] 胡雁,郝玉芳.循证护理学[M].2版.北京:人民卫生出版社,2018:58-82.
[9] JBI. Critical Appraisal Tools[EB/OL].[2024-01-02]. https://jbi.global/critical-appraisal-tools.
[10] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.DOI:10.16821/j.cnki.hsjx.2015.11.002.
[11] Gomes GC, Moreira RDS, Maia TO, et al.[Factors associated with personal autonomy among the elderly: a systematic review of the literature][J]. Cien Saude Colet,2021,26(3):1035-1046. DOI:10.1590/1413-81232021263.08222019.
[12] Bay AA, Prizer L, Orusa A, et al.Effects of a health education and research participation enhancement program on participation and autonomy in diverse older adults[J].Gerontol Geriatr Med, 2020(6):598964200. DOI:10.1177/2333721420924952.
[13] Sánchez IM, Santacreu M, Olmos R, et al.A training intervention to reduce paternalistic care and promote autonomy: a preliminary study[J]. Clin Interv Aging,2019(14):1515-1525. DOI:10.2147/CIA.S213644.
[14] 程彦如, 李亚楠. 自我效能在失能老人负性情绪与健康促进生活方式间的中介效应分析[J]. 护理实践与研究, 2023,20(13):1901-1905.
[15] 李婷婷,韩月华,安若楠,等.养老机构老年人健康促进生活方式现况及其影响因素[J].现代养生, 2023, 23(6):429-434. DOI:10.3969/j.issn.1671-0223(s).2023.06.009.
[16] 高梦珂,张艳,田雨同,等.河南省部分农村老人健康促进生活方式现状及影响因素研究[J].现代预防医学,2022,49(2):263-267.
[17] 程兆辉,贺知菲,许小兰,等.农村地区老年人健康知识、健康行为及影响因素研究[J].中国卫生事业管理,2022,39(8):600-605.
[18] 尚芳芳. 脑卒中失能老年患者健康促进与家庭功能相关性研究[J].中国疗养医学,2020,29(6):600-602. DOI:10.13517/j.cnki.ccm.2020.06.013.
[19] Cristina I, Magda R, Paulo M, et al.Functional capacity and self-care profiles of older people in senior care homes[J]. Scand J Caring Sci,2020,34(1):69-77. DOI:10.1111/scs.12706.
[20] Liu LH, Kao CC, Ying JC.Functional capacity and life satisfaction in older adult residents living in long-term care facilities: the mediator of autonomy[J]. J Nurs Res,2020,28(4):e102. DOI:10.1097/JNR.0000000000000362.
[21] Sánchez GS, García PC, Ramírez GE, et al. Decreased autonomy in community-dwelling older adults[J]. Clin Interv Aging,2019(18):14:2041-2053. DOI:10.2147/CIA.S225479.
[22] 赵江豪,唐菀,兰梦雪,等.成都市老年人健康促进生活方式和影响因素研究[J].现代预防医学,2018,45(4):663-665,699.
[23] 程彦如,路雪芹,陈传波,等.河南开封农村失能老年人健康行为及影响因素研究[J].现代预防医学,2016,43(6):1057-1060.
[24] 张虹,沈军,贾倩颖,等.主动健康视角下养老机构失能老年人“给予式照护”困境的质性研究[J]. 中华护理杂志,2023, 58(22):2761-2768. DOI:10.3761/j.issn.0254-1769.2023.22.011.
[25] Hedman M, Häggström E, Mamhidir A, et al.Caring in nursing homes to promote autonomy and participation[J]. Nurs Ethics, 2019, 26(1):280-292.DOI:10.1177/0969733017703698.
[26] Breitholtz A, Snellman I, Fagerberg I.Older people's dependence on caregivers' help in their own homes and their lived experiences of their opportunity to make independent decisions[J]. Int J Older People Nurs,2013,8(2):139-148. DOI:10.1111/j.1748-3743.2012.00338.x
[27] Davies M, Zúñiga F, Verbeek H, et al.Exploring interrelations between person-centered care and quality of life following a transition into long-term residential care: a Meta-ethnography[J]. Gerontologist,2023,63(4):660-673. DOI:10.1093/geront/gnac027.
[28] Moilanen T, Suhonen R, Kangasniemi M.Nursing support for older people's autonomy in residential care: an integrative review[J]. Int J Older People Nurs,2022,17(2):e12428. DOI:10.1111/opn.12428.
[29] Lynch B, Ryan AA, O'Neill M, et al. The factors that influence care home residents' and families' engagement with decision-making about their care and support: an integrative review of the literature[J]. BMC Geriatr,2022,17,22(1):873. DOI:10.1186/s12877-022-03503-8.
[30] Moilanen T, Kangasniemi M, Papinaho O, et al.Older people's perceived autonomy in residential care: an integrative review[J]. Nurs Ethics,2021,28(3):414-434. DOI:10.1177/0969733020948115.
[31] Fjordside S, Morville A.Factors influencing older people's experiences of participation in autonomous decisions concerning their daily care in their own homes: a review of the literature[J]. Int J Older People Nurs,2016,11(4):284-297. DOI:10.1111/opn.12116.
[32] 邓艳红,赵雪艳,和静,等.云南某民族自治县居民健康素养现状及其影响因素研究[J].卫生软科学,2023,37(2):83-89. DOI:10.3969/j.issn.1003-2800.2023.02.018.
[33] 张馨月,齐丽娜,陈长香,等.不同人生及生老病死态度高龄老年人健康促进行为状况[J].华北理工大学学报(医学版),2020,22(5):365-370. DOI:10.19539/j.cnki.2095-2694.2020.05.006.
[34] Fingerman KL, Ng YT, Huo M, et al.Functional limitations, social integration, and daily activities in late life[J]. J Gerontol B Psychol Sci Soc Sci,2021, 76(10):1937-1947. DOI:10.1093/geronb/gbab014.
[35] 吴凡,绳宇.社区老年人社会隔离与健康促进行为的差异化研究[J].中国全科医学,2019,22(22):2744-2748. DOI:10.12114/j.issn.1007-9572.2019.00.372.
[36] 程令伟,王瑜.农村失能老人“自我维持型”照护困境与应对路径[J].华中农业大学学报(社会科学版),2021(6):129-137. DOI:10.13300/j.cnki.hnwkxb.2021.06.014.

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