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痴呆症护理导航:不同服务类型及其流行率的系统评价。

Dementia care navigation: A systematic review on different service types and their prevalence.

机构信息

Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.

NIHR Applied Research Collaboration North West Coast, Liverpool, UK.

出版信息

Int J Geriatr Psychiatry. 2023 Aug;38(8):e5977. doi: 10.1002/gps.5977.

Abstract

BACKGROUND

Dementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing service formats, and to synthesise evidence regarding their implementation and impacts.

METHODS

The review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN service, defined as a service in which non-clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst.

RESULTS

We included 14 papers reporting on six studies. All services were US-based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well-being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions and studies employing different outcome measures. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages.

CONCLUSIONS

DCN services have the potential to effectively provide non-clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar established outcome measures are required.

摘要

背景

痴呆症护理导航员(DCN)是没有临床培训的专业人员,他们为患有痴呆症的人提供个性化的情感和实际支持,与临床服务一起工作。导航员服务已经实施,但提供的服务各不相同,没有提供一致的概述。本叙述性系统评价的目的是描述和比较现有的服务模式,并综合关于其实施和影响的证据。

方法

该综述在 PROSPERO(CRD42021292518)上进行了注册。我们搜索了三个电子数据库,并纳入了报道痴呆症护理导航员服务的研究,该服务定义为非临床培训工作人员为社区中的痴呆症患者和/或照顾者提供个性化建议和支持的服务。两名独立的评审员筛选了摘要和标题,并阅读了全文以确定是否纳入。使用标准质量评估工具 QualSyst 评估偏倚风险。

结果

我们纳入了 14 篇报道了 6 项研究的论文。所有的服务都来自美国,只是在整合和培训方面有所不同。研究报告了对服务利用以及痴呆症患者及其照顾者的症状和心理健康产生不同程度的影响,但证据太少,无法得出实质性/有意义的结论,并且研究采用了不同的结果衡量标准。一项研究表明,与早期阶段相比,该服务对处于更晚期的痴呆症患者的影响更大。

结论

痴呆症护理导航员服务有可能从诊断开始为痴呆症患者及其照顾者提供有效的非临床支持。需要来自美国以外的国家开展进一步的研究,重点关注对社会护理和社会支持服务的利用和影响,并使用类似的既定结果衡量标准。

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