Mathews Rebecca, O'Malley Chris, Hall Jenny M, Macaden Leah, MacRury Sandra
Division of Rural Health and Wellbeing, Centre for Health Science, University of the Highlands and Islands, Inverness, United Kingdom.
Highland Health Sciences Library, Centre for Health Science, University of the Highlands and Islands, Inverness, United Kingdom.
JMIR Diabetes. 2019 Apr 22;4(2):e11526. doi: 10.2196/11526.
Diabetes is increasing in prevalence and complexity in the care home setting, affecting up to a quarter of care home residents. Health outcomes for these residents are impacted by management of the disease, health care professionals (HCPs)' decision-making skills within the care home setting, and access to specialist services. The use of technology has the potential to recognize opportunities for early intervention that enables efficient responsive care, taking a fundamental role in linking the care home community to wider multidisciplinary teams for support.
The aim of this paper was to identify evidence that explores factors relevant to the use of technology in and around the care home setting to aid in the management of diabetes.
Databases searched using a structured prespecified approach included: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), OVID Nursing database, Scopus, MEDLINE, the Cochrane Library, and the King's Fund from 2012 to 2017: handsearching was undertaken additionally for any gray literature. Preferred Reporting Items for Systematic review and Meta-Analysis Protocol was used as protocol with Risk of Bias in Systematic reviews a tool to assess the risk of bias across studies. Studies had to include interventions that combined technology to or from the care home setting to support residents living with diabetes.
The combined search strategy identified a total of 493 electronic records. Of these, 171 papers were screened for eligibility, 66 full papers were accessed, and 13 have been included in this study. Qualitative synthesis has identified different strands of research evidence in what and how technology is currently being used in and around care homes to enhance diabetes management. New initiatives and implementations of technology and emerging models of care that included the use of technology have also been included.
By triangulating the perspectives of HCPs, practitioners, specialists, and members of the care home community, the authors anticipate that this review will represent an up-to-date, evidence-based overview of the potential for using technology within the care home setting for diabetes management as well as stimulate research in this area.
在养老院环境中，糖尿病的患病率和复杂性日益增加，影响着多达四分之一的养老院居民。这些居民的健康状况受到疾病管理、医疗保健专业人员（HCPs）在养老院环境中的决策技能以及获得专科服务的影响。技术的使用有可能识别早期干预的机会，从而实现高效的响应式护理，在将养老院社区与更广泛的多学科团队联系以获得支持方面发挥重要作用。
本文旨在识别探索与在养老院环境及其周边使用技术以辅助糖尿病管理相关因素的证据。
使用结构化的预先指定方法搜索的数据库包括：2012年至2017年的PubMed、CINAHL（护理学与健康相关文献累积索引）、OVID护理学数据库、Scopus、MEDLINE、Cochrane图书馆和国王基金；另外还对手头资料进行了手工检索。系统评价和Meta分析方案的首选报告项目被用作方案，系统评价中的偏倚风险作为评估各研究偏倚风险的工具。研究必须包括将技术与养老院环境相结合或从养老院环境中获取技术以支持糖尿病患者的干预措施。
综合搜索策略共识别出493条电子记录。其中，筛选了171篇论文以确定其是否符合资格，获取了66篇全文，本研究纳入了13篇。定性综合分析确定了不同方面的研究证据，涉及目前在养老院及其周边如何使用技术来加强糖尿病管理。还包括技术的新举措和实施情况以及包括使用技术在内的新兴护理模式。
通过综合HCPs、从业者、专家和养老院社区成员的观点，作者预计本综述将代表一份关于在养老院环境中使用技术进行糖尿病管理潜力的最新、基于证据的概述，并将激发该领域的研究。
