Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Bone Microsurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Int J Orthop Trauma Nurs. 2024 Feb;52:101060. doi: 10.1016/j.ijotn.2023.101060. Epub 2023 Oct 24.
Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors.
To gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms.
Based on the "6 S" pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence.
Thirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted.
The study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients.
骨质疏松性骨折是骨质疏松症的一种严重并发症,通常需要手术治疗,其恢复与患者自身行为和生活方式密切相关,是一个长期、复杂的管理过程,通常需要患者自我管理许多与健康相关的因素。
收集和综合关于术后骨质疏松性骨折患者自我管理的最有力证据,为临床医护人员提供科学、循证指导,协助术后患者进行自我管理,帮助患者优化自我管理实践和行为规范。
基于证据资源的“6S”金字塔模型(系统、综述、综合摘要、综合、研究摘要、研究),检索 UpToDate、BMJ Best Practice、The Cochrane Library、澳大利亚乔安娜·布里格斯研究所循证医学中心卫生保健数据库、英国国家卫生与临床优化研究所(NICE)、指南国际网络(GIN)、国家指南清除中心(NGC)和苏格兰校际指南网络(SIGN)、MedPulse、Embase、PubMed、CINAHL、Web of Science、SinoMed、中国医学全文数据库、中国知网、万方数据知识服务平台和维普数据库等,检索临床决策、系统评价、临床指南、自我管理术后骨质疏松性骨折患者的证据总结和专家共识,检索时间为 2023 年 2 月 18 日。为保证文献质量,3 位研究人员严格按照文献纳入和排除标准筛选文献,2 位以上研究人员独立评价纳入文献质量,并提取和综合相关证据。
最终纳入 13 篇文献,包括 4 篇临床实践指南、5 篇专家共识、2 篇推荐实践、1 篇系统评价和 1 篇临床决策报告。研究团队从多学科团队协作、日常生活管理、治疗依从性管理、运动管理、预防跌倒和随后骨折的管理以及情绪管理 6 个维度总结证据,提取了 33 条证据。
本研究总结了 33 项关于术后骨质疏松性骨折患者自我管理的最佳证据,为术后患者提供了科学合理的自我管理方案,也为临床医护人员为患者提供更全面、更科学的自我管理健康教育提供了重要参考和信息。