Faculty of Nursing, Midwifery and Health, University of Technology Sydney, Australia.
Worldviews Evid Based Nurs. 2013 Feb;10(1):17-40. doi: 10.1111/j.1741-6787.2012.00255.x. Epub 2012 Jun 4.
Stroke produces many effects that impact eating. Nutrition is fundamental for recovery and rehabilitation, but the nursing nutritional role and associated outcomes have not been delineated.
(1) To identify nursing interventions intended to improve nutritional status and related outcomes of stroke survivors, and (2) To examine the outcomes of identified nursing interventions on nutrition-related outcomes, including dietary intake, functional status, complications, activities of daily living, mortality, and quality of life for stroke survivors.
A modified version of Cochrane literature searching and review methods was used to identify studies that described and evaluated nursing nutritional interventions for adult stroke patients in hospital and community settings. A minimum of 10 years content of seven databases and nine journals was searched to March 2011. Findings were presented descriptively.
In total 27 papers from 26 studies were included: 5 randomized controlled trials, 5 clinical trials, 6 quasi-experiments, 4 case studies, and 6 qualitative/observational studies. Stroke nursing nutritional care encompassed screening of nutritional status and swallowing function; assessment of nutritional characteristics and preferences; referral; mealtime organization, supervision and monitoring; mealtime assistance and feeding skills. Nurses individualized care, coordinated or managed meal delivery and enteral feeding systems, were responsible for the dining environment and conduct of mealtimes; they taught staff, patients, and carers. There was little indication of integrated or psychosocial nursing nutritional care, or concepts, theories or models of nursing nutritional care. Many interventions were described but not evaluated. Little high quality evidence was of available.
This review indicated the parameters of nursing nutritional care, and provided a framework for future research. A functional, supportive, and educational nursing nutritional role was described but little evidence was of sufficient quality to support policy and practice development or inform education. Nutritional care was revealed as an essential but under-recognized element of stroke nursing.
中风会产生许多影响进食的影响。营养对于康复和恢复至关重要，但护理营养角色及其相关结果尚未确定。
（1）确定旨在改善中风幸存者营养状况和相关结果的护理干预措施，（2）检查确定的护理干预措施对营养相关结果的影响，包括饮食摄入、功能状态、并发症、日常生活活动、死亡率和中风幸存者的生活质量。
使用改良版 Cochrane 文献搜索和综述方法，确定描述和评估医院和社区环境中成年中风患者护理营养干预措施的研究。搜索了七个数据库和九种期刊的至少 10 年内容，截至 2011 年 3 月。结果以描述性方式呈现。
共纳入 26 项研究的 27 篇论文：5 项随机对照试验、5 项临床试验、6 项准实验、4 项病例研究和 6 项定性/观察性研究。中风护理营养护理包括营养状况和吞咽功能筛查；评估营养特征和偏好；转介；进餐时间组织、监督和监测；进餐协助和喂养技能。护士个性化护理、协调或管理膳食供应和肠内喂养系统、负责就餐环境和进餐时间管理；他们还教授工作人员、患者和护理人员。几乎没有迹象表明有综合或心理社会护理营养护理，也没有护理营养护理的概念、理论或模型。许多干预措施被描述但没有被评估。几乎没有高质量的证据可用。
本综述表明了护理营养护理的参数，并为未来的研究提供了框架。描述了一种功能性、支持性和教育性的护理营养角色，但几乎没有足够质量的证据支持政策和实践发展或为教育提供信息。营养护理被揭示为中风护理中不可或缺但未被充分认识的要素。
