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受ADAPTE方法启发制定脊髓损伤患者压疮临床实践指南。

Development of a clinical practice guideline on pressure ulcers in people with spinal cord injuries inspired by the ADAPTE method.

作者信息

Soegaard Knaerke, Beeckman Dimitri, Verhaeghe Sofie, Biering-Sørensen Fin, Sørensen Jens Ahm

机构信息

Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark.

Department of Clinical Research, Health Sciences, University of Southern Denmark, Odense, Denmark.

出版信息

Spinal Cord. 2025 Feb;63(2):66-74. doi: 10.1038/s41393-024-01051-z. Epub 2024 Dec 9.

DOI:10.1038/s41393-024-01051-z
PMID:39653739
Abstract

STUDY DESIGN

Guideline adaptation study using the ADAPTE method.

OBJECTIVE

The aim of this study was the development and validation of a Danish clinical practice guideline for PU/PI prevention and treatment for people with SCI through adaptation of existing guidelines.

METHODS

The ADAPTE method is a systematic framework used to adapt existing clinical practice guidelines to a new context, such as a different healthcare setting or population. This method ensures that the adapted guidelines are relevant, evidence-based, and practical for the specific context in which they will be implemented.

SETTING

Relevant stakeholders and treatment units within the Danish healthcare system involved in the rehabilitation, treatment, and care of people with SCI.

RESULTS

The adaptation yielded 22 topics and 121 recommendations, which underwent external review. Stakeholders gave positive feedback and qualified the recommendations. However, they also highlighted challenges in implementation due to the complexity of PU/PI prevention and treatment and organizational issues within the Danish healthcare system.

CONCLUSIONS

This study has resulted in the development of a comprehensive Danish clinical practice guideline tailored specifically for the prevention and treatment of PU/PI among people with SCI within the Danish healthcare system. The external review emphasizes the imperative for continuous research aimed at strengthening evidence-based approaches to both prevention and treatment. Furthermore, it highlights the necessity for systematic dissemination strategies to facilitate the integration of the guideline into clinical practice.

摘要

研究设计

采用ADAPTE方法进行指南改编研究。

目的

本研究的目的是通过改编现有指南,制定并验证丹麦针对脊髓损伤患者压力性溃疡/压力性损伤预防和治疗的临床实践指南。

方法

ADAPTE方法是一个系统框架,用于使现有临床实践指南适用于新环境,如不同的医疗环境或人群。该方法确保改编后的指南与将实施该指南的特定环境相关、基于证据且实用。

背景

丹麦医疗系统内参与脊髓损伤患者康复、治疗和护理的相关利益相关者和治疗单位。

结果

改编产生了22个主题和121条建议,并进行了外部审查。利益相关者给予了积极反馈并认可了这些建议。然而,他们也强调了由于压力性溃疡/压力性损伤预防和治疗的复杂性以及丹麦医疗系统内的组织问题,在实施过程中存在挑战。

结论

本研究制定了一份专门针对丹麦医疗系统内脊髓损伤患者压力性溃疡/压力性损伤预防和治疗的全面丹麦临床实践指南。外部审查强调了持续开展研究以加强预防和治疗的循证方法的必要性。此外,它突出了制定系统传播策略以促进将该指南融入临床实践的必要性。

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本文引用的文献

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"I am just trying to live a life!" -a qualitative study of the lived experience of pressure ulcers in people with spinal cord injuries.“我只是想过正常生活!”——一项关于脊髓损伤患者压疮生活体验的质性研究
J Tissue Viability. 2024 Feb;33(1):50-59. doi: 10.1016/j.jtv.2023.11.009. Epub 2023 Nov 29.
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Interventions, stakeholders, and organisation related to pressure ulcer prevention for individuals with spinal cord injuries in transition from hospital to home - A scoping review.干预措施、利益相关者和组织与脊髓损伤患者从医院到家庭过渡期间的压疮预防相关 - 范围综述。
J Tissue Viability. 2023 May;32(2):194-205. doi: 10.1016/j.jtv.2023.02.005. Epub 2023 Feb 14.
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全球脊髓损伤患者压疮负担:系统评价和荟萃分析。
BMC Musculoskelet Disord. 2020 May 29;21(1):334. doi: 10.1186/s12891-020-03369-0.
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GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction.GRADE证据到决策(EtD)框架:一种做出明智医疗选择的系统且透明的方法。1:引言。
BMJ. 2016 Jun 28;353:i2016. doi: 10.1136/bmj.i2016.
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The cost of prevention and treatment of pressure ulcers: A systematic review.预防和治疗压疮的成本:系统评价。
Int J Nurs Stud. 2015 Nov;52(11):1754-74. doi: 10.1016/j.ijnurstu.2015.06.006. Epub 2015 Jun 25.
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Are labour-intensive efforts to prevent pressure ulcers cost-effective?预防压疮的劳力密集型措施是否具有成本效益?
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