家庭和社区服务:系统审查和证据地图
M Hassan Murad1, Tarek Nayfeh2, Samer Saadi2
1Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA. Murad.mohammad@mayo.edu.
Journal of general internal medicine
|August 13, 2024
概括
家庭和社区服务 (HCBS) 支持功能有限的老年人独立. 本综述绘制了HCBS证据,确定了研究和政策中的差距,以改善医疗服务.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
背景情况:
- 高龄成年人 (60岁以上) 经常面临功能限制,需要家庭和社区服务 (HCBS) 来保持独立性并避免制度化.
- 进行了系统审查,以绘制有关HCBS的现有证据,旨在确定未来研究和政策制定的关键差距.
研究的目的:
- 系统地绘制有关老年人家庭和社区服务 (HCBS) 的现有文献.
- 确定与HCBS相关的人口,干预,结果,以人为中心以及质量措施的证据差距.
- 为未来关于HCBS的研究优先事项和政策决策提供信息.
主要方法:
- 在多个数据库 (Medline,Embase,Scopus) 进行了全面的文献搜索,截至2023年12月7日.
- 对利益相关者进行了采访,以收集有关HCBS的不同观点.
- 用叙事和主题综合来分析HCBS关于人口,干预,结果,以人为中心和质量的文献.
主要成果:
- 确定了27项初级研究和29项质量测量措施,涵盖功能障碍,认知障碍和高风险状况的人群.
- 干预措施包括以人为中心的规划,痴呆症护理,康复,自我指导的护理和护理协调;然而,以人为中心和社会需求的代表性不足.
- 存在许多质量指标,但挑战包括有限的随机试验,不充分的干预描述,以及关于促进者,障碍和劳动力问题的数据不足.
结论:
- 目前的证据地图突出显示了老年人HCBS研究的现状.
- 存在显著的证据差距,特别是关于以人为中心的规划,自我指导和解决与健康相关的社会需求的明确描述.
- 需要进一步的研究来解决干预细节,促进者,障碍,劳动力挑战,并加强有效HCBS政策和实践的证据基础.
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