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住院患者活动的结果:一项文献综述。

Outcomes of inpatient mobilization: a literature review.

作者信息

Kalisch Beatrice J, Lee Soohee, Dabney Beverly W

机构信息

School of Nursing, University of Michigan, Ann Arbor, MI, USA.

出版信息

J Clin Nurs. 2014 Jun;23(11-12):1486-501. doi: 10.1111/jocn.12315. Epub 2013 Sep 13.

Abstract

AIMS AND OBJECTIVES

To review current research evidence on the outcomes of mobilising hospitalised adults.

BACKGROUND

Although immobility is known to cause functional decline or complications, inpatient ambulation emerged as the most often missed element of nursing care. This study is designed to review research studies that give evidence as to the consequences of mobilising or not mobilising hospitalised adult patients.

DESIGN

A literature review of published peer-reviewed empirical research was undertaken.

METHODS

The electronic databases of MEDLINE (Ovid), CINAHL, and PubMed were accessed to search for relevant empirical articles, supplemented by a search of reference lists contained in retrieved articles and citation tracking.

RESULTS

Thirty-six studies were identified for inclusion in the review. Four areas (study design, sample size, measurement and statistical analysis) were evaluated for methodological quality, and most studies showed strong quality. A synthesis of the findings generated four themes of the effects of inpatient mobilisation: (1) physical outcomes included pain, deep vein thrombosis, fatigue, etc.; (2) psychological outcomes included anxiety, depressive mood, distress, comfort and satisfaction; (3) social outcomes included quality of life and independence; and (4) organisational outcomes included length of stay, mortality and cost.

CONCLUSION

Mobilising hospitalised adults brings benefits for not only physical functioning, but also their emotional and social well-being. Moreover, ambulation yields important organisational benefits. These benefits of mobilisation on four areas required viewing the patient in a holistic manner. Even though each study approached different types of patients, illnesses and procedures, this review showed that most inpatients would benefit from mobilisation and would experience optimal functions.

RELEVANCE TO CLINICAL PRACTICE

The importance of mobilisation for positive patient outcomes highlights the need to develop methods to ensure that this nursing action is completed on a systematic basis.

摘要

目的与目标

回顾目前关于住院成人活动效果的研究证据。

背景

尽管已知活动受限会导致功能衰退或并发症,但住院患者的下床活动却是护理中最常被忽视的环节。本研究旨在回顾那些能为住院成年患者活动或不活动的后果提供证据的研究。

设计

对已发表的同行评审实证研究进行文献综述。

方法

检索MEDLINE(Ovid)、CINAHL和PubMed的电子数据库,以查找相关实证文章,并通过检索所检索文章中的参考文献列表和引文跟踪进行补充。

结果

确定了36项研究纳入综述。对四个方面(研究设计、样本量、测量和统计分析)进行了方法学质量评估,大多数研究显示质量较高。研究结果综合产生了住院患者活动效果的四个主题:(1)身体方面的结果包括疼痛、深静脉血栓形成、疲劳等;(2)心理方面的结果包括焦虑、抑郁情绪、痛苦、舒适度和满意度;(3)社会方面的结果包括生活质量和独立性;(4)组织方面的结果包括住院时间、死亡率和成本。

结论

让住院成人活动不仅对身体功能有益,对他们的情绪和社会幸福感也有益。此外,下床活动还能带来重要的组织效益。活动在这四个方面的益处要求以整体的方式看待患者。尽管每项研究涉及不同类型的患者、疾病和程序,但本综述表明,大多数住院患者将从活动中受益并实现最佳功能。

与临床实践的相关性

活动对患者产生积极结果的重要性凸显了开发方法以确保这一护理行动能系统完成的必要性。

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