初级保健或社区保健专业人员为支持居家痴呆症患者进行日常生活活动而提供的干预措施：系统评价和叙述性综合。

Interventions delivered by primary or community healthcare professionals to support people living at home with dementia with activities of daily living: a systematic review and narrative synthesis.

机构信息

NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute King's College London, Virginia Woolf Building 22 Kingsway, London, WC2B 6LE, UK.

School of Health Sciences, University of Southampton, Southampton General Hospital, Tremona Road, Shirley, SO16 6YD, UK.

出版信息

BMC Geriatr. 2024 Oct 23;24(1):860. doi: 10.1186/s12877-024-05465-5.

DOI:10.1186/s12877-024-05465-5

PMID:39443920

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11515696/

Abstract

BACKGROUND

Most people living with dementia live in their own home supported by family carers. One of the most challenging problems they face is managing toilet-use and continence. Carers have repeatedly asked for better advice from healthcare professionals. The purpose of this systematic review was to inform the development of an intervention to support healthcare professionals to provide existing continence management advice to the carers of people living at home with dementia. It aimed to identify and synthesise lessons from the development and evaluation of interventions, involving primary or community healthcare professionals, to support the provision of management advice aimed at supporting people living at home with dementia and their carers with activities of daily living. Due to a lack of relevant continence or toilet-use interventions, this included, but was not limited to, toileting or continence care.

METHODS

Literature (February 2009-November 2022) was searched using five databases: MEDLINE (Ovid); PsycINFO (Ovid); EMBASE (Ovid); Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO); and Cochrane Central Register of Controlled Trials (CENTRAL). Empirical studies using a variety of methodologies were included and thus the quality of papers appraised using the Mixed-Methods Appraisal Tool. No studies were excluded based on quality. A narrative synthesis was undertaken.

RESULTS

Twelve articles reporting on 10 interventions were included. Most comprised the provision of online resources only, although some combined these with online or face-to-face contact with healthcare professionals. A variety of methodologies was utilised including randomised controlled trials. The quality of included studies was variable. Six main themes were identified: mode of delivery; targeted and tailored resources; content, design and navigation; credibility; user involvement in the development and evaluation of information resources; and role of professionals and organisations.

CONCLUSIONS

Despite the urgent need to better support people living at home with dementia and their carers, this review highlights the paucity of studies reporting on interventions delivered within primary and community healthcare contexts to provide management advice aimed at supporting this population with activities of daily living. This review has identified important considerations that will potentially aid the development, delivery and evaluation of such interventions.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42022372456.

摘要

背景

大多数患有痴呆症的人都在家中居住，由家人照顾。他们面临的最具挑战性的问题之一是管理如厕和控制大小便。照顾者一再要求医护人员提供更好的建议。本系统评价的目的是为开发一项干预措施提供信息支持，以帮助医护人员为家中患有痴呆症的人及其照顾者提供现有的控便管理建议。其目的是确定并综合参与初级或社区医疗保健专业人员的干预措施的经验教训，以支持提供旨在支持家中患有痴呆症的人和他们的照顾者进行日常生活活动的管理建议。由于缺乏相关的控便或如厕干预措施，因此这包括但不限于如厕或控便护理。

方法

使用五个数据库（Ovid 中的 MEDLINE；Ovid 中的 PsycINFO；Ovid 中的 EMBASE；EBSCO 中的 Cumulative Index to Nursing and Allied Health Literature（CINAHL）；CENTRAL 中的 Cochrane Central Register of Controlled Trials）于 2009 年 2 月至 2022 年 11 月期间对文献进行检索。纳入了使用各种方法学的实证研究，因此使用混合方法评估工具（Mixed-Methods Appraisal Tool）评估论文的质量。未基于质量排除任何研究。进行了叙述性综合。

结果

纳入了 12 篇报道 10 项干预措施的文章。大多数干预措施仅提供在线资源，尽管有些干预措施将这些资源与与医护人员的在线或面对面接触相结合。使用了各种方法学，包括随机对照试验。纳入研究的质量参差不齐。确定了六个主要主题：传递方式；有针对性和定制化的资源；内容、设计和导航；可信度；在开发和评估信息资源方面用户的参与；以及专业人员和组织的作用。