摘要
目的 遴选并获取痴呆患者口腔健康管理的相关证据,并对最佳证据进行总结.方法 计算机检索BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、美国指南网、英国国家临床医学研究所指南库、Cochrane Library、PubMed、阿尔茨海默病协会网站、中国生物医学文献数据库、中国知网、万方数据库、维普网等关于痴呆及认知障碍患者口腔健康管理的所有证据,包括最佳临床实践、指南、专家共识、证据总结、推荐实践和系统评价.检索时限为建库至2023年10月31日.由2～4名研究者对纳入的文献进行质量评价,并对符合质量标准的文献进行证据提取.结果 最终纳入11篇证据文献,包括指南2篇、证据总结5篇、推荐实践1篇、系统评价3篇.总结出31条最佳证据,证据内容涉及团队合作、人员培训、口腔评估、口腔清洁操作、义齿管理、沟通和行为管理策略、特殊口腔问题干预和健康教育8个维度.结论 痴呆患者的口腔健康管理有其特殊性且患者口腔并发症发生率高,应加强医护人员的认知及培训,注重口腔评估、口腔护理及沟通技巧,积极预防及处理特殊口腔问题,以提高患者口腔健康水平.此外,建议临床应用证据前,先评估患者文化差异、所在医疗机构临床环境、患者意愿等,再有针对性地实施证据措施.
Abstract
Objective To select and obtain evidence on oral health management for dementia patients,and summarize the best evidence.Methods The best clinical practices,guidelines,expert consensus,evidence summary,recommended practices,and systematic reviews on oral health management for patients with dementia and cognitive impairment were electronically retrieved from British Medical Journal Best Practice,Australia Joanna Briggs Institute Evidence-Based Health Care Center Database,Agency for Healthcare Research and Quality,and National Institute for Health and Clinical Excellence,Cochrane Library,PubMed,Alzheimer's Association,China Biomedical Database,China National Knowledge Infrastructure,WanFang Data and VIP and so on.The search period was from database establishment to October 31,2023.Two to four researchers evaluated the quality of the included literature and extracted evidence from the literature that met the quality standards.Results A total of 11 articles were included,including two guidelines,five evidence summaries,one recommended practice,and three systematic reviews.A total of 31 best pieces of evidence were summarized from eight aspects,including team work,personnel training,oral assessment,oral cleaning procedures,denture management,communication and behavior management,interventions for special oral problems,and health education.Conclusions The oral health management of dementia patients has its particularity and the incidence of oral complications is high.It is necessary to strengthen the awareness and training of medical and nursing staff,pay attention to oral assessment,oral care,and communication skills,actively prevent and handle special oral problems,so as to improve the oral health of patients.In addition,it is recommended to evaluate patient cultural differences,clinical environment of the medical institution,patient willingness and so on before applying evidence in clinical practice,and then implement targeted evidence measures.
维普
万方数据