Jaiswal Atul, Gupta Shikha, Paramasivam Abinethaa, Santhakumaran Sangeetha, Holzhey Peter, Dupont Patrice, Wittich Walter
School of Optometry, Université de Montréal, Montreal, Quebec, Canada.
CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Quebec, Canada.
Innov Aging. 2022 Dec 16;7(1):igac076. doi: 10.1093/geroni/igac076. eCollection 2023.
A global report estimates up to 2% of the world population experience concurrent hearing and vision impairment (dual sensory impairment [DSI]). Older adults with DSI are often frequent users of health care, yet the evidence is limited to inform care delivery for this population. This systematic review aimed to synthesize evidence on tools and strategies for screening, assessment, and interventions that promote a continuum of care for older adults with DSI.
The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health, and Web of Science) and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched. The quality appraisal was performed using the Mixed Methods Appraisal Tool.
Of 4,775 identified references, 28 records were selected. The review identified 7 tools and 7 strategies for DSI-specific screening, assessments, and/or interventions. Some of the most promising tools were the interRAI Community Health Assessment with deafblind supplement, adapted Montreal Cognitive Assessment, and the Severe Dual Sensory Loss screening tool. Useful strategies included the use of alternative forms of communication, assistive devices or technology, education and training for service providers, and training of older adults on the use and maintenance of assistive aids/technology. However, quality appraisal indicated a need for more robust evidence to inform clinical practice.
Reviewed evidence pinpointed the need for training for health care providers on DSI-specific challenges and supports and the use of integrated multidisciplinary care for older adults. Future studies need to explore the development and evaluation of tools and interventions to improve the continuum of care for this group. PROSPERO registration # CRD42020180545.
一份全球报告估计，全球多达2%的人口同时存在听力和视力障碍（双重感官障碍[DSI]）。患有DSI的老年人通常频繁使用医疗保健服务，但为这一人群提供护理的相关证据有限。本系统评价旨在综合有关促进患有DSI的老年人持续护理的筛查、评估和干预工具及策略的证据。
本评价按照系统评价的首选报告项目进行。检索了电子数据库（CINAHL、Embase、MEDLINE、PsycINFO、Cochrane图书馆、全球卫生数据库和科学引文索引）以及临床试验注册库（ISRCTN注册库、世界卫生组织国际临床试验平台和ClinicalTrials.gov）。使用混合方法评价工具进行质量评估。
在4775条识别出的参考文献中，选择了28条记录。该评价确定了7种针对DSI的筛查、评估和/或干预工具及7种策略。一些最有前景的工具包括带有聋盲补充版的间互用性居民健康评估、改编版蒙特利尔认知评估和严重双重感官丧失筛查工具。有用的策略包括使用替代沟通形式、辅助设备或技术、对服务提供者进行教育和培训，以及对老年人进行辅助器具/技术使用和维护方面的培训。然而，质量评估表明需要更有力的证据来为临床实践提供参考。
审查的证据指出，需要对医疗保健提供者进行关于DSI特定挑战及支持方面的培训，并对老年人使用综合多学科护理。未来的研究需要探索工具和干预措施的开发与评估，以改善该群体的持续护理。PROSPERO注册号#CRD42020180545。
