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急性护理环境中痴呆患者的健康结果——系统评价。

Health outcomes of patients with dementia in acute care settings-A systematic review.

机构信息

Institute of Health and Biomedical Innovation, School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia.

Evidence in Practice Unit, Queensland Centre for Evidence Based Nursing and Midwifery, Mater Health, South Brisbane, Qld, Australia.

出版信息

Int J Older People Nurs. 2020 Sep;15(3):e12315. doi: 10.1111/opn.12315. Epub 2020 Mar 24.

Abstract

BACKGROUND

An ageing population has resulted in increased numbers of people with dementia attending acute care services; however, the impact of hospitalisation on this population is uncertain.

PURPOSE

This systematic review aimed to synthesise the available evidence on adverse health outcomes for people with dementia in acute care settings.

METHODS

A systematic search of CINAHL, PubMed, MEDLINE, EMBASE and Scopus databases for primary research articles in English language, published from 2000 to 2017, was conducted. A protocol for the review was registered on the PROSPERO database.

RESULTS

The initial search identified 5,520 records. Following removal of duplicates and assessment against inclusion criteria, 13 studies were included in the final review. Findings identify associations between patients with dementia, longer length of hospital stay and higher mortality in some situations. Heterogeneity across studies in data reporting and outcomes prevented meta-analysis; therefore, results are presented narratively.

CONCLUSIONS

Certainty of findings from this review is impacted by variation in patient condition and data reporting. Additional rigorous studies on health outcomes for people with dementia during acute hospitalisation will contribute to the evidence.

IMPLICATIONS FOR PRACTICE

These findings along with further research examining outcomes for patients with dementia in acute care settings will inform provision of safer, quality care and optimal health outcomes for this vulnerable population.

摘要

背景

人口老龄化导致越来越多的痴呆症患者入住急性护理服务;然而,住院对这一人群的影响尚不确定。

目的

本系统评价旨在综合现有关于急性护理环境中痴呆症患者不良健康结局的证据。

方法

对 CINAHL、PubMed、MEDLINE、EMBASE 和 Scopus 数据库进行了系统检索,以查找 2000 年至 2017 年发表的英文原始研究文章。该评价的方案已在 PROSPERO 数据库中注册。

结果

最初的搜索确定了 5520 条记录。在去除重复项并根据纳入标准进行评估后,最终有 13 项研究纳入了最终评价。研究结果发现,在某些情况下,痴呆症患者与住院时间延长和死亡率升高之间存在关联。由于数据报告和结果存在异质性,无法进行荟萃分析;因此,结果以叙述性方式呈现。

结论

本评价结果的确定性受到患者病情和数据报告变化的影响。在急性住院期间对痴呆症患者健康结局进行更多严格的研究将有助于充实证据。

实践意义

这些发现以及进一步研究急性护理环境中痴呆症患者的结局,将为这一脆弱人群提供更安全、更优质的护理和更理想的健康结局提供信息。

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