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影响居住在长期护理机构中的老年人实施循证预防跌倒干预措施的因素——系统评价的伞形综述

Factors Influencing the Implementation of Evidence-Based Falls Prevention Interventions for Older Persons Living in Residential long-term care settings - An Umbrella Review of Systematic Reviews.

作者信息

Scerri Anthony, Lungaro-Mifsud Stephen

机构信息

Department of Nursing, Faculty of Health Sciences, Mater Dei Hospital, B'Kara, Malta.

Department of Physiotherapy, Faculty of Health Sciences, University of Malta, Malta.

出版信息

J Frailty Sarcopenia Falls. 2025 Jun 1;10(2):87-107. doi: 10.22540/JFSF-10-087. eCollection 2025 Jun.

Abstract

Falls among older adults in residential long-term care (RLTC) remain a significant concern, with prevention efforts often yielding inconsistent results due to the complexity of implementation. This umbrella review synthesised evidence from ten systematic reviews to explore the factors influencing the implementation of falls prevention interventions in RLTC, using the i-PARIHS framework. Six EBSCO databases and Scopus were searched without date or language limiters. Risk of bias was assessed using the AMSTAR-2 checklist. The review was conducted in accordance with the PRIOR guideline for overviews of reviews. Seventy-three specific factors were identified. Interventions that are simple, engaging, tailored, and supported by leadership were more effectively adopted. Staff knowledge, clarity of roles, and multidisciplinary collaboration and co-design further facilitated implementation, while organisational constraints such as limited resources, rigid routines, and under-resourcing posed substantial barriers. External contextual influences, including funding mandates and policy frameworks. Moreover, this review identified four factors that did not fall under any of the key characteristics of the i-PARIHS framework: , and . This review underscores the importance of contextually sensitive, system-wide strategies that consider the evolving realities of RLTC.

摘要

在长期居住护理机构(RLTC)中,老年人跌倒仍然是一个重大问题,由于实施过程的复杂性,预防措施往往产生不一致的结果。本综合性综述利用i-PARIHS框架,综合了十项系统综述的证据,以探讨影响RLTC中跌倒预防干预措施实施的因素。检索了六个EBSCO数据库和Scopus,没有日期或语言限制。使用AMSTAR-2清单评估偏倚风险。该综述是根据PRIOR综述概述指南进行的。确定了73个具体因素。简单、有吸引力、量身定制且有领导支持的干预措施更容易被有效采用。员工知识、角色清晰度、多学科协作和共同设计进一步促进了实施,而资源有限、常规僵化和资源不足等组织限制则构成了重大障碍。外部背景影响,包括资金要求和政策框架。此外,本综述确定了四个不属于i-PARIHS框架任何关键特征的因素: ,以及 。本综述强调了考虑RLTC不断变化的现实情况、因地制宜的全系统策略的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4787/12138986/5d4a5439425e/JFSF-10-087-g001.jpg

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