电子健康干预措施对护理院中痴呆患者评估和决策支持的可接受性与有效性：一项系统综述

The acceptability and effectiveness of eHealth interventions to support assessment and decision-making for people with dementia living in care homes: A systematic review.

作者信息

Tunnard India, Gillam Juliet, Harvey Catherine, Davies Nathan, Vickerstaff Victoria, Ellis-Smith Clare, Evans Catherine J

机构信息

Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom.

Research Department of Primary Care and Population Health, University College London, London, United Kingdom.

出版信息

Front Dement. 2022 Sep 13;1:977561. doi: 10.3389/frdem.2022.977561. eCollection 2022.

DOI:10.3389/frdem.2022.977561

PMID:39081472

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11285551/

Abstract

INTRODUCTION

As dementia progresses, care needs increase leading many to require 24-h care in care homes. eHealth interventions have the potential to improve care processes of assessment and decision-making for people with dementia. However, little is known on the acceptability and effectiveness in care homes.

AIM

To identify and explore the components, acceptability and effectiveness of eHealth interventions for people with dementia, families and staff to support assessment and decision-making in care homes.

METHODS

A mixed methods systematic review using narrative synthesis. Four databases were searched (Embase, PsycINFO, MEDLINE, and CINAHL) from 2000 to July 2021. Quality appraisal used validated assessment tools appropriate for the study design.

RESULTS

Twenty-six studies met eligibility criteria. Study designs and interventions were heterogeneous. Overall quality was high to moderate. Interventions that promoted supportive, practical learning through integrated working and provided staff with language to communicate resident symptoms were favored by staff. We found evidence that indicated residents were willing to use video consultations; however, families preferred face-to-face consultations. Fifteen studies considered effectiveness. Use of eHealth interventions indicates an improvement in resident outcomes in appropriate prescribing and advance care planning. Staff knowledge, confidence, and wellbeing were also improved. Hospitalisations were reduced when a video consultation component was implemented.

DISCUSSION

Care home staff require support to meet the often multiple and changing care needs of residents with dementia. eHealth interventions can improve outcomes for staff and residents and facilitate integrated working with external professionals to support assessment and management of care. Further work is required to understand acceptability for residents and their families and effectiveness on family outcomes, particularly in non-Western cultures and low-middle income countries.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=254967, identifier: CRD42021254967.

摘要

引言

随着痴呆症病情的发展，护理需求不断增加，许多患者需要在养老院接受24小时护理。电子健康干预措施有潜力改善痴呆症患者的评估和决策护理流程。然而，对于养老院中的可接受性和有效性知之甚少。

目的

识别并探索针对痴呆症患者、其家人及工作人员的电子健康干预措施的组成部分、可接受性和有效性，以支持养老院中的评估和决策。

方法

采用叙述性综合的混合方法系统评价。检索了2000年至2021年7月期间的四个数据库（Embase、PsycINFO、MEDLINE和CINAHL）。质量评估使用适合研究设计的经过验证的评估工具。

结果

26项研究符合纳入标准。研究设计和干预措施各不相同。总体质量为高到中等。通过综合协作促进支持性、实用性学习并为工作人员提供用于沟通居民症状的语言的干预措施受到工作人员的青睐。我们发现有证据表明居民愿意使用视频咨询；然而，家人更喜欢面对面咨询。15项研究考虑了有效性。电子健康干预措施的使用表明在适当开药和预先护理计划方面居民的结局有所改善。工作人员的知识、信心和幸福感也得到了提高。实施视频咨询组件后住院次数减少。