Smith Graeme D, Watson Roger, Thompson David R
School of Health in Social Science, The University of Edinburgh, Edinburgh, UKSchool of Nursing & Midwifery, The University of Sheffield, Sheffield, UKDepartment of Health Sciences, University of Leicester, Leicester, UK.
J Clin Nurs. 2008 Nov;17(11c):400-6. doi: 10.1111/j.1365-2702.2008.02577.x.
To review the literature on inflammatory bowel disease in older and younger people and to identify whether they included a nursing or psychosocial perspective, or were informed by theories of ageing.
Inflammatory bowel disease, manifested as Crohn's disease and ulcerative colitis, affects younger and older people and is associated with a range of psychosocial factors. Nurses have an important role to play in caring for people with inflammatory bowel disease.
A systematic review of literature related to inflammatory bowel disease and older people was carried out using the MEDLINE, CINAHL EMBASE and Cochrane databases between 1990-2006.
Generally speaking, the clinical features of inflammatory bowel disease are similar in younger and older people, as are indications for surgery, survival and the usual wide spectrum of severity of disease. Corticosteroid treatment carries additional risk for older people. The studies used both retrospective and prospective designs, with the former using patient records, and the latter using follow-up of patients with inflammatory bowel disease. Sample sizes were adequate for statistical analyses but there was no reference to reliability or validity of data collection methods. None of the studies considered psychosocial aspects, or the role of nurses in caring for people with inflammatory bowel disease. A specific gerontological perspective was lacking from the papers reviewed. While the clinical features of inflammatory bowel disease are similar in younger and older people, with the bimodal distribution of age of onset of inflammatory bowel disease, the possibility exists that quality of life and adjustment in older people depend on age of onset. This has not been investigated. Future lines of enquiry taking psychosocial aspects of inflammatory bowel disease into account in older people are explored.
Nurses play an increasingly important role in the assessment and management of inflammatory bowel disease patients. Little is known about factors which could predict poorer psychosocial health and the impact non-intestinal manifestations may have on this in older people with inflammatory bowel disease.
回顾关于年轻人和老年人炎症性肠病的文献，确定这些文献是否包含护理或社会心理视角，或者是否受到衰老理论的影响。
炎症性肠病表现为克罗恩病和溃疡性结肠炎，影响年轻人和老年人，并与一系列社会心理因素相关。护士在照顾炎症性肠病患者方面发挥着重要作用。
使用MEDLINE、CINAHL、EMBASE和Cochrane数据库，对1990年至2006年间与炎症性肠病和老年人相关的文献进行系统综述。
一般来说，年轻人和老年人炎症性肠病的临床特征相似，手术指征、生存率以及疾病严重程度的常见广泛范围也相似。皮质类固醇治疗对老年人有额外风险。这些研究采用了回顾性和前瞻性设计，前者使用患者记录，后者对炎症性肠病患者进行随访。样本量足以进行统计分析，但未提及数据收集方法的可靠性或有效性。没有一项研究考虑社会心理方面，或护士在照顾炎症性肠病患者中的作用。所审查的论文缺乏特定的老年医学视角。虽然年轻人和老年人炎症性肠病的临床特征相似，但炎症性肠病发病年龄呈双峰分布，老年人的生活质量和适应情况可能取决于发病年龄。这一点尚未得到研究。探讨了未来在老年人炎症性肠病中考虑社会心理方面的研究方向。
护士在炎症性肠病患者的评估和管理中发挥着越来越重要的作用。对于可能预测较差社会心理健康的因素以及非肠道表现对老年炎症性肠病患者的影响知之甚少。
