摘要
目的:检索、筛选、评价、整合老年人定向障碍管理的相关证据并汇总,为医护人员及照顾者对定向障碍老年人的管理提供循证依据.方法:计算机检索国内外相关数据库、指南网站及相关专业网站中关于老年人定向障碍管理的证据,包括指南、最佳实践、专家共识、证据总结、系统评价以及随机对照试验.检索时限为建库至 2024 年 4月2日.由 4 名研究者独立对指南进行质量评价、2 名研究者独立对其余文献进行质量评价及证据提取、汇总.结果:共纳入 9 篇文献,包括1篇临床实践指南、2 篇专家共识、2 篇系统评价、4 篇随机对照试验.最终形成时间定向障碍管理、空间定向障碍管理、人物定向障碍管理以及定向力训练 4 个方面18 条证据.结论:医护人员及照顾者在应用证据时可结合老年人意愿及实际情景,适时推动证据的转化及临床应用,从而降低定向障碍对老年人生活及预后的不良影响.
Abstract
Objective:To systematically search,screen,evaluate,and integrate relevant evidence on the management of orientation disorders in the elderly,and to form the best evidence summary,so as to provide evidence-based basis for medical staff and caregivers in the management of elderly people with disorientation.Methods:A comprehensive computerized search was conducted from relevant databases,guideline websites,and related professional websites at home and abroad from the inception of the database to April 2,2024.The search included guidelines,best practices,expert consensus,evidence summaries,systematic reviews,Meta-analyses,and Randomized Controlled Trials(RCTs).Four researchers independently evaluated the quality of the guidelines,and two researchers independently evaluated the quality of the remaining literature,extracted,and summarized the evidence.Results:A total of 9 articles were included,including 1 clinical practice guideline,2 expert consensus statements,2 systematic reviews,and 4 RCTs,which altogether summarized 18 pieces of evidence on the prevention and management of time orientation disorders,spatial orientation disorders,person orientation disorders,and comprehensive interventions.Conclusion:This study summarizes the best evidence for the management of orientation disorders in the elderly.Medical staff and caregivers can timely promote the conversion and clinical application of evidence according to the actual situations and patients'willingness,thereby reducing the adverse effects of orientation disorders on their life and prognosis.
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