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支持择期退行性脊柱手术后患者康复的出院后护理干预措施:一项系统综述

Post-discharge care interventions to support patient recovery after elective degenerative spine surgery: a systematic review.

作者信息

Lorenzen Marianne Dyrby, Wickstrøm Line Adsbøll, Andersen Mikkel Østerheden, Carreon Leah Yacat, Clemensen Jane, Frandsen Tove Faber

机构信息

Spine Surgery & Research, Spine Centre of Southern Denmark, Lillebaelt Hospital, - University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark.

Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.

出版信息

Eur Spine J. 2025 Mar;34(3):1042-1054. doi: 10.1007/s00586-024-08622-x. Epub 2024 Dec 19.

Abstract

PURPOSE

To characterize the type, content, and results of care interventions that support spine surgery patients in their early post-discharge recovery.

METHODS

This systematic review was conducted according to PRISMA guidelines. The literature search was conducted in March 2022 (updated in May 2023) in MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ebsco), PsycINFO (Ovid), and Scopus. Given the heterogeneity of the interventions, outcome parameters, and controls, data for pooling for meta-analysis was not possible. We performed a thematic analysis to categorize the characteristics of the type, content, and results of care interventions.

RESULTS

A total of 14 articles met the eligibility criteria. The included studies were published between 2008 and 2022 and included 1,399 unique patients with mean reported ages of 42.3 to 62.3 years. The reported interventions were divided into two categories: "Early active rehabilitation" and "Telemonitoring". As for pain, function, quality of life, and activity the majority of the early active rehabilitation interventions showed no differences compared to usual care. In contrast, the telemonitoring interventions seemed mainly to be in favor of the interventions versus usual care in all of the aforementioned aspects.

CONCLUSION

The included studies demonstrated diverse interventions across settings, populations, interventions, controls, follow-up times, and outcome measures. This variability suggests unclear patient needs and preferences for post-discharge care. Given the heterogeneity and overall study quality, further high-quality research is essential. Future studies should prioritize identifying these needs before intervention design.

摘要

目的

描述在脊柱手术患者出院后早期康复过程中提供支持的护理干预措施的类型、内容和效果。

方法

本系统评价按照PRISMA指南进行。2022年3月(2023年5月更新)在MEDLINE(Ovid)、EMBASE(Ovid)、CINAHL(Ebsco)、PsycINFO(Ovid)和Scopus数据库中进行文献检索。鉴于干预措施、结局参数和对照的异质性,无法汇总数据进行荟萃分析。我们进行了主题分析,以对护理干预措施的类型、内容和效果的特征进行分类。

结果

共有14篇文章符合纳入标准。纳入的研究发表于2008年至2022年之间,共纳入1399例患者,报告的平均年龄为42.3至62.3岁。报告的干预措施分为两类:“早期主动康复”和“远程监测”。在疼痛、功能、生活质量和活动方面,与常规护理相比,大多数早期主动康复干预措施没有差异。相比之下,远程监测干预措施在上述所有方面似乎主要有利于干预组而非常规护理组。

结论

纳入的研究表明,在环境、人群、干预措施、对照、随访时间和结局测量方面存在多种干预措施。这种变异性表明患者对出院后护理的需求和偏好不明确。鉴于异质性和整体研究质量,进一步开展高质量研究至关重要。未来的研究应在干预设计之前优先确定这些需求。

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