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非药物性谵妄检测和管理干预措施在家庭中对老年人非正式照护者的应用:系统评价方案。

Non-pharmacological delirium detection and management interventions for informal caregivers of older people at home: A scoping review protocol.

机构信息

School of Nursing, York University, Toronto, Ontario, Canada.

York University Centre for Aging Research and Education, Toronto, Ontario, Canada.

出版信息

PLoS One. 2024 Sep 20;19(9):e0308886. doi: 10.1371/journal.pone.0308886. eCollection 2024.

Abstract

OBJECTIVE

The objective of this proposed scoping review is to identify and map the available evidence on interventions that aim to help informal caregivers identify and/or manage delirium in an older person at home.

INTRODUCTION

Delirium is a neurocognitive condition characterized by acute confusion and is associated with increased risk of morbidity and mortality. Research estimates delirium to be present in 17% of community-dwellers aged 85 and older, increasing proportionally with age to 45% in those aged 90 and older. Delirium often occurs at the onset of an older person's acute illness or exacerbation of a chronic illness (sometimes while at home) and, because of its protracted nature, usually continues after a hospital stay. Even when an older person's delirium resolves during hospitalization, they remain at risk of its recurrence after discharge home. Consequently, knowing how to detect and manage delirium is critical for informal caregivers of older people at home. However, there are no reviews focused exclusively on this topic in this setting.

INCLUSION CRITERIA

The population of interest includes informal caregivers of a person aged 65+. Concepts of interest include delirium detection and/or management interventions. The context of interest is any setting where informal care is delivered, including the transition from hospital to home, in any geographical area.

MATERIALS AND METHODS

The review will be conducted according to the JBI guidelines for scoping reviews. A three-step search strategy will be used to locate both published and unpublished papers in MEDLINE, Embase, CINAHL, PsycINFO, Web of Science Core Collection, ProQuest Nursing & Allied Health, SCOPUS, LILACS, and SciELO, PQD&T, NDLTD, Google Scholar and Google. No language restrictions will be placed on the review. Papers will be screened for eligibility at the title, abstract, and full text level by two independent reviewers. Data will be extracted by two independent reviewers and managed in Covidence. Any disagreements in screening or data extraction will be resolved by consensus or a third reviewer. Results will be summarised in narrative and tabular formats.

摘要

目的

本研究旨在对旨在帮助家庭中非正式照护者识别和/或管理老年人谵妄的干预措施进行识别和绘制现有证据图谱。

引言

谵妄是一种以急性意识混乱为特征的神经认知障碍,与发病率和死亡率增加相关。研究估计,85 岁及以上的社区居民中有 17%存在谵妄,随着年龄的增长,这一比例呈比例增加,在 90 岁及以上的人群中达到 45%。谵妄通常发生在老年人急性疾病发作或慢性疾病恶化时(有时在家中),由于其持续时间较长,通常在住院后仍会持续。即使老年人在住院期间谵妄得到缓解,他们在出院回家后仍有复发的风险。因此,了解如何识别和管理谵妄对家庭中的老年人非正式照护者至关重要。然而,在这一背景下,没有专门针对这一主题的综述。

纳入标准

研究对象为年龄在 65 岁及以上的老年人的非正式照护者。感兴趣的概念包括谵妄的检测和/或管理干预措施。感兴趣的背景是提供非正式照护的任何环境,包括从医院到家庭的过渡,在任何地理区域都可以。

材料和方法

本研究将按照 JBI 指南进行综述。将采用三步搜索策略在 MEDLINE、Embase、CINAHL、PsycINFO、Web of Science 核心合集、ProQuest 护理与联合健康、SCOPUS、LILACS 和 SciELO、PQD&T、NDLTD、Google Scholar 和 Google 中查找已发表和未发表的论文。本综述将不对语言进行限制。将由两名独立审查员对论文进行标题、摘要和全文筛选,以确定其是否符合纳入标准。两名独立审查员将提取数据,并在 Covidence 中进行管理。如果在筛选或数据提取过程中存在分歧,将通过协商或第三名审查员解决。结果将以叙述性和表格形式进行总结。

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本文引用的文献

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Diagnostic accuracy of the Family Confusion Assessment Method for delirium detection: A systematic review and meta-analysis.
J Am Geriatr Soc. 2024 Mar;72(3):892-902. doi: 10.1111/jgs.18692. Epub 2023 Nov 29.
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Educational intervention for family caregivers of older adults with delirium: An integrative review.
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Persistent delirium in older hospital patients: an updated systematic review and meta-analysis.
Delirium (Bielef). 2022 Aug 9;1:36822. doi: 10.56392/001c.36822.
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Recommendations for the extraction, analysis, and presentation of results in scoping reviews.
JBI Evid Synth. 2023 Mar 1;21(3):520-532. doi: 10.11124/JBIES-22-00123.
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Enferm Intensiva (Engl Ed). 2022 Jan-Mar;33(1):33-43. doi: 10.1016/j.enfie.2021.01.003. Epub 2022 Feb 8.
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Family intervention for delirium for patients in the intensive care unit: A systematic meta-analysis.
J Clin Neurosci. 2022 Feb;96:114-119. doi: 10.1016/j.jocn.2021.11.011. Epub 2021 Nov 24.

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