Torrens University Australia, Adelaide, SA, 5000, Australia.
Faculty of Health, National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia.
Syst Rev. 2024 Jun 10;13(1):154. doi: 10.1186/s13643-024-02576-3.
Frailty reduction and reversal have been addressed successfully among older populations within community settings. However, these findings may not be applicable to residential care settings, largely due to the complex and multidimensional nature of the condition. Relatively, few attempts at frailty prevention exist in residential settings. This review aims to identify and describe best practice models of care for addressing frailty among older populations in residential care settings. This research also sets out to explore the impact of multidisciplinary health service delivery models on health outcomes such as mortality, hospitalisations, quality of life, falls and frailty.
A scoping review of the literature was conducted to address the project objectives. Reference lists of included studies, bibliographic databases and the grey literature were systematically searched for literature reporting multidisciplinary, multidimensional models of care for frailty.
The scoping review found no interventions that met the inclusion criteria. Of the 704 articles screened, 664 were excluded as not relevant. Forty articles were fully assessed, and while no eligible studies were found, relevant data were extracted from 10 near-eligible studies that reported single disciplines or single dimensions rather than a model of care. The physical, nutritional, medicinal, social and cognitive aspects of the near eligible studies have been discussed as playing a key role in frailty reduction or prevention care models.
This review has identified a paucity of interventions for addressing and reducing frailty in residential care settings. High-quality studies investigating novel models of care for addressing frailty in residential care facilities are required to address this knowledge gap. Similarly, there is a need to develop and validate appropriate screening and assessment tools for frailty in residential care populations. Health service providers and policy-makers should also increase their awareness of frailty as a dynamic and reversible condition. While age is a non-modifiable predictor of frailty, addressing modifiable factors through comprehensive care models may help manage and prevent the physical, social and financial impacts of frailty in the ageing population.
在社区环境中，已经成功地减少和逆转了老年人的脆弱性。然而，这些发现可能不适用于居住护理环境，主要是由于这种情况的复杂和多维性质。相对而言，居住环境中预防脆弱性的尝试相对较少。本综述旨在确定和描述针对居住在护理环境中的老年人脆弱性的最佳护理模式，并探讨多学科卫生服务提供模式对死亡率、住院率、生活质量、跌倒和脆弱性等健康结果的影响。
对文献进行了范围综述，以解决项目目标。系统地搜索了包括研究的参考文献列表、书目数据库和灰色文献，以寻找报告多学科、多维脆弱性护理模式的文献。
该范围综述未发现符合纳入标准的干预措施。在筛选的 704 篇文章中，有 664 篇被排除在外，认为与研究无关。对 40 篇文章进行了全面评估，虽然没有找到符合条件的研究，但从 10 篇接近符合条件的研究中提取了相关数据，这些研究报告了单一学科或单一维度，而不是护理模式。接近符合条件的研究的身体、营养、药物、社会和认知方面被认为在减少或预防脆弱性护理模型方面发挥了关键作用。
本综述发现，针对居住护理环境中脆弱性的干预措施很少。需要高质量的研究来调查针对居住护理设施中脆弱性的新护理模式，以填补这一知识空白。同样，需要为居住在护理人群中的脆弱性开发和验证适当的筛查和评估工具。卫生服务提供者和政策制定者还应提高对脆弱性作为一种动态和可逆状况的认识。虽然年龄是脆弱性的不可改变预测因素，但通过综合护理模式解决可改变的因素可能有助于管理和预防老龄化人口中脆弱性的身体、社会和经济影响。
