老年肿瘤患者跌倒评估及管理最佳证据总结

doi:10.16460/j.issn1008-9969.2021.18.022

摘要/Abstract

摘要： 目的总结老年肿瘤患者跌倒评估及管理的最佳证据,为我国临床实践提供参考依据。方法使用PICO模型确定循证问题,计算机检索有关老年肿瘤患者跌倒评估及管理的证据资源,包括指南、证据总结、最佳实践信息册、专家共识、系统评价、文献综述、随机对照研究。由2名完成循证护理培训课程的研究者分别进行文献筛选、文献质量评价、证据级别划分、证据提取及汇总。结果最终纳入7篇文献,包括指南3篇,系统评价1篇,文献综述2篇,随机对照研究1篇,从跌倒风险初步筛查、跌倒风险综合评估、干预措施3个维度总结了26条最佳证据。结论评估是预防老年肿瘤患者跌倒的前提,采取综合的干预措施能有效预防老年肿瘤患者跌倒的发生。最佳证据的应用,需结合医护人员的专业判断,综合考虑患者的需求和偏好、应用证据的场景,分析障碍和促进因素,以制订符合我国临床实践的老年肿瘤患者跌倒评估及管理策略。

关键词: 肿瘤患者, 跌倒, 评估, 管理, 最佳证据, 循证护理

Abstract: Objective To summarize the best evidence for the assessment and management of falls in elderly cancer patients, and to provide reference for clinical practice in China. Methods With PICO model, the evidence-based questions were identified; computer-based retrieval of evidence resources for falls assessment and management including guidelines, summary of evidence, best practice information book, expert consensus, systematic review, literature review, and randomized controlled trials in elderly cancer patients was performed. Literature screening, literature quality evaluation, classification of evidence grade and recommendation grade, evidence extraction and summary were conducted by 2 researchers who completed the evidence-based nursing training. Results Seven articles were included, including 3 guidelines, 1 systematic review, 2 literature reviews, and 1 randomized controlled trial and 26 pieces of best evidence were summarized from 3 dimensions of initial screening, comprehensive evaluation and intervention measures. Conclusion Assessment is the premise to prevent the falls of elderly cancer patients and comprehensive intervention is effective for the prevention of the falls of elderly cancer patients. The application of the best evidence should be based on the professional judgment of the medical staff, the needs and preferences of the patients, the application context of the evidence, and the analysis of barriers and facilitating factors, so as to formulate the evaluation and management strategy of falls for elderly cancer patients in accordance with clinical practice in China.

Key words: cancer patient, fall, assessment, management, best evidence, evidence-based nursing

中图分类号:

蔡莹莹, 张俊峰, 郑可欣, 张兰芳, 余璐萍, 曾文, 陈梦云, 黄琼珊. 老年肿瘤患者跌倒评估及管理最佳证据总结[J]. 护理学报, 2021, 28(18): 22-27.

CAI Ying-ying, ZHANG Jun-feng, ZHENG Ke-xin, ZHANG Lan-fang, YU Lu-ping, ZENG Wen, CHEN Meng-yun, HUANG Qiong-shan. Best Evidence Summary for Assessment and Management of Falls in Elderly Cancer Patients[J]. Journal of Nursing, 2021, 28(18): 22-27.

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