在急性护理环境中实施脆弱性评估工具:一个范围审查
Harneet Hothi1,2, Arianna R Paolone2,3, Matteen Pezeshki2
1Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Journal of the American Geriatrics Society
|March 15, 2025
概括
这次审查发现了许多方法来衡量医院的脆弱性,脆弱性指数是最常见的. 然而,大多数研究都侧重于将脆弱性与结果联系起来,而不是使用评估来改善患者护理.
科学领域:
- 老年学是一门学科.
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 虚弱是老年人不良健康结果的重要预测因素.
- 在急性护理环境中测量脆弱性是具有挑战性的,因为缺乏标准化工具和实施困难.
- 现有的脆弱性评估方法差异很大,导致临床医生感到困惑.
研究的目的:
- 对如何在急性护理环境中测量和利用脆弱性进行范围审查.
- 绘制和综合目前的脆弱性评估工具和它们在医院中的应用.
主要方法:
- 利用阿克西和奥马利的方法论框架进行范围审查.
- 在多个数据库 (MEDLINE,EMBASE,CINAHL,SCOPUS,Google Scholar) 进行了全面的搜索.
- 包括到2023年5月发表的评估急性护理环境中的脆弱性的初级研究.
主要成果:
- 从8834篇文章的初步搜索中确定了2554项相关研究,过去五年出版物的数量大幅增加.
- 最常用的脆弱性评估工具是脆弱性指数 (41.0%),临床脆弱性量表 (23.3%),和炸脆弱性表型 (9.3%).
- 绝大多数研究 (99.6%) 专注于脆弱性和不良结果之间的关联或工具验证,对未来护理适应的研究很少 (0.4%).
结论:
- 虽然有证据强烈地将急性护理中的脆弱性与不良结果联系在一起,但关于脆弱性评估对主动修改患者护理的影响的研究存在着显著的差距.
- 进一步的研究对于在急性护理环境中探索和建立潜在的脆弱性管理策略至关重要.
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