针对复杂护理需求的跨学科过渡性护理干预措施的影响:系统性审查和元分析
Romain Collet1,2, Juul van Grootel3,4, Johanna van Dongen1
1Faculty of Science, Department of Health Sciences, Vrije University Amsterdam, Amsterdam Movement Sciences Research Institute, Musculoskeletal Health, Amsterdam, The Netherlands.
The Gerontologist
|March 5, 2025
概括
多学科过渡期护理干预措施 (MTCI) 在减少老年患者再入院和死亡率方面表现有前途. 这些干预措施也改善了生活质量和身体表现,复杂的干预措施带来了更大的好处.
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
- 证据综合 证据综合
背景情况:
- 多学科过渡性护理干预 (MTCI) 旨在改善患者的护理协调和连续性,特别是老年人,医院出院后.
- 这些干预措施解决了身体,营养,认知和心理领域的复杂患者需求.
- 需要对证据进行全面的综合分析,以评估MTCI的有效性.
研究的目的:
- 系统地识别,批判性地评估和综合现有关于跨学科过渡期护理干预措施有效性的证据.
- 评估MTCI对患者再入院,死亡率和各种健康相关结果的影响.
主要方法:
- 在Medline,Embase,CINAHL和CENTRAL数据库中进行了系统的文献搜索,直到2024年7月.
- 包括评估MTCI的随机对照试验 (RCT),并使用Bias-2工具评估偏差风险.
- 证据的确定性和子组分析的可信性分别使用GRADE和ICE方法进行评估.
主要成果:
- 该分析包括了49项试验,包括25566名患者,显示MTCI减少再入院的确定性很低 (RR 0.88),但减少死亡率的确定性很高 (RR 0.92).
- 低至中等的确定性表明,MTCI可以改善身体生活质量 (SMD 0.54),心理生活质量 (SMD 0.44),患者满意度 (SMD 0.49),以及身体表现 (SMD 0.49).
- 小组分析表明,更复杂的MTCI显著提高了身体表现 (SMD 0.83).
结论:
- 多学科过渡期护理干预措施在减少患者再入院和死亡率方面表现出有效性.
- 肌痛治疗药物有助于改善患者的生活质量和身体能力.
- 建议将MTCI定制为特定患者群体和医疗保健环境,以最大限度地发挥它们的积极影响.
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