Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
Central Clinical School, Monash University; Kolling Institute, the University of Sydney, Sydney, Australia.
BMC Fam Pract. 2020 Jul 13;21(1):141. doi: 10.1186/s12875-020-01177-y.
The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged. Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published literature to identify existing and potential roles of Practice Nurse's in the delivery of care to people affected by dementia and to describe the characteristics and effectiveness of nurse interventions in dementia models of care.
The PRISMA statement guided the systematic review of the quantitative and qualitative evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search of seven electronic databases and Google scholar identified relevant original research published in English between January 2000 and January 2019. Thirteen articles met the inclusion criteria and were extracted into the Covidence software for analysis.
The heterogeneity of the included studies purpose, design and outcomes measures and the diversity in health systems and primary care nurses scope of practice made it difficult to synthesise the findings and draw conclusions. The heterogeneity did, however, provide important insights into the characteristics of roles undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person. These included patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners.
Embedding an evidence-based model that describes the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia.
PROSPERO 2018 CRD42018088191.
已经认识到扩大执业护士角色以包括识别和管理痴呆症的潜在价值。执业护士非常适合提供全面的痴呆症信息和支持，以使痴呆症患者能够更好地自我管理健康，并在患有痴呆症的情况下过上更好的生活。本综述的目的是系统地检查已发表的文献，以确定执业护士在为受痴呆症影响的人群提供护理方面的现有和潜在角色，并描述护士干预在痴呆症护理模式中的特征和效果。
PRISMA 声明指导了对执业护士在提供痴呆症护理方面的角色和特征的定量和定性证据的系统评价。对 7 个电子数据库和 Google Scholar 进行了全面的文献检索，以确定 2000 年 1 月至 2019 年 1 月期间以英文发表的相关原始研究。有 13 篇文章符合纳入标准，并被提取到 Covidence 软件中进行分析。
纳入研究的目的、设计和结果测量的异质性以及卫生系统和初级保健护士的实践范围的多样性使得很难综合研究结果并得出结论。然而，这种异质性为在一般实践环境中工作的护士所承担的角色特征提供了重要的见解，这些角色特征对与痴呆症患者及其照顾者有益。这些特征包括患者是否能够接触到执业护士、认知变化的早期识别和管理、护理管理以及与全科医生的合作。执业护士提供痴呆症护理的局限性包括角色定义不明确、缺乏专门的痴呆症培训、时间限制以及与全科医生沟通不畅。
将描述执业护士在痴呆症护理提供中的角色的循证模型纳入其中，有可能增加对认知障碍的早期识别，并更恰当地对痴呆症进行初级保健管理。
PROSPERO 2018 CRD42018088191。
