家庭预康复:随机试验的系统审查和元分析
Filippo D'Amico1, Sara Dormio1, Giulia Veronesi2
1Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
British journal of anaesthesia
|February 7, 2025
概括
基于家庭的预康复计划通过减少术后并发症和提高功能能力来增强患者的康复. 这种方法证明了良好的坚持,并提供了一个资源高效的替代方案,以医院的干预措施.
科学领域:
- 老年学和康复医学 老年学和康复医学
- 基于证据的外科手术实践.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 预康复计划的目的是通过多学科干预来提高术前功能能力.
- 基于家庭的预康复提供了一个资源高效的替代传统的医院为基础的计划.
- 评估家庭预康复的坚持和临床有效性对于优化患者护理至关重要.
研究的目的:
- 系统地审查家庭预康复的随机对照试验.
- 评估家庭预康复对术后并发症和功能能力的影响.
- 评估患者的坚持和对心理健康和住院时间的影响.
主要方法:
- 在PubMed,Cochrane和Embase数据库中进行了系统的搜索,直到2024年10月1日.
- 包括随机对照试验比较了家庭预康复与标准护理.
- 主要结局:术后并发症;次要结局:坚持,6分钟步行测试,抑郁,焦虑和住院时间.
主要成果:
- 纳入了29项随机试验,涉及3508名患者,其中位数依从率为82%.
- 基于家庭的预康复显著减少了术后并发症 (RR 0.84,P=0.02),确定性低.
- 在6分钟步行测试中观察到改善,抑郁,焦虑和住院时间减少.
结论:
- 基于家庭的预康复在减少术后并发症方面是有效的,尽管证据的确定性很低.
- 这项干预表明了良好的坚持,并改善了功能能力,心理健康,并减少了住院时间.
- 基于家庭的预康复提供了一个可行的和有效的策略,以提高手术患者的治疗结果.
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