School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia.
J Clin Nurs. 2019 Dec;28(23-24):4236-4249. doi: 10.1111/jocn.15041. Epub 2019 Sep 30.
To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services.
Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care-related harm, such as falls, delirium and poor nutrition. To minimise the risk of health care-related harm, volunteer programmes to support patient care have been established in many hospitals worldwide.
A systematic scoping review.
The review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) (File S1). Nine databases were searched (CINAHL, MEDLINE, EMBASE, Cochrane, Scopus, Web of Science, PubMed, ScienceDirect and JBI) using the following key terms: 'hospital', 'volunteer', 'sitter', 'acute care', 'older adults', 'confusion', 'dementia' and 'frail'. The search was limited to papers written in English and published from 2002-2017. Inclusion criteria were studies involving the use of hospital volunteers in the care or support of older adult patients aged ≥ 65 years, or ≥ 50 years for Indigenous peoples, with chronic health conditions, cognitive impairment and/or physical decline or frailty, within the acute inpatient settings.
Of the 199 articles identified, 17 articles that met the inclusion criteria were critically appraised for quality, and 12 articles were included in the final review.
There is evidence that the provision of volunteer care and support with eating and drinking, mobilising and therapeutic activities can impact positively upon patient health outcomes related to nutrition, falls and delirium. Further robust research is needed to determine the impact of volunteers in acute care and the specific care activities that can contribute to the best outcomes for older adults.
Volunteers can play a valuable role in supporting care delivery by nurses and other health professionals in acute care services, and their contribution can improve health outcomes for older adults in this setting.
考察志愿者提供的护理和支持对急性护理服务中老年患者健康结果的影响。
急性住院患者人群日趋老龄化，这可能导致健康结果恶化。慢性健康状况、多药治疗以及认知和功能下降等因素与医疗相关伤害（如跌倒、谵妄和营养不良）的风险增加相关。为了最大程度降低医疗相关伤害的风险，全世界许多医院都建立了志愿者支持患者护理的计划。
系统范围界定审查。
本研究遵循 PRISMA 扩展范围界定综述（PRISMA-ScR）（文件 S1）。使用以下关键词在九个数据库中进行检索（CINAHL、MEDLINE、EMBASE、Cochrane、Scopus、Web of Science、PubMed、ScienceDirect 和 JBI）：“医院”、“志愿者”、“护工”、“急性护理”、“老年人”、“混乱”、“痴呆”和“虚弱”。检索仅限于 2002-2017 年以英文发表的论文。纳入标准为：在急性住院环境中，使用医院志愿者对年龄≥65 岁或土著人群≥50 岁、患有慢性健康状况、认知障碍和/或身体衰退或虚弱的老年患者进行护理或支持的研究。
在 199 篇文章中，有 17 篇符合纳入标准，对其进行了质量评价，最终有 12 篇文章纳入综述。
有证据表明，提供志愿者护理和支持，包括进食和饮水、活动和治疗活动，可以对营养、跌倒和谵妄等与患者健康结果相关的方面产生积极影响。需要进一步开展更有力的研究，以确定志愿者在急性护理中的作用以及可以促进老年患者最佳结果的具体护理活动。
志愿者可以在急性护理服务中为护士和其他卫生专业人员提供护理支持方面发挥宝贵作用，他们的贡献可以改善该环境中老年患者的健康结果。
