护士主导干预对儿科患者出现狂妄症的有效性:系统性审查和元分析
Cong-Hui Fu1, Min-Jie Ju1, Yan Li1
1Department of Critical Care Medicine, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
护士主导的干预措施有效地减少了儿童的出现妄想 (ED),改善了结果,并缓解了焦虑和疼痛. 需要进一步的研究来探索对PACU停留和诱导合规性的影响.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 护理干预 护理干预
- 证据综合 证据综合
背景情况:
- 突发性妄想 (ED) 是儿科麻醉中常见的一个问题.
- 护士主导的干预措施在管理ED方面表现有前途,但儿科证据有限.
- 这项研究解决了对儿童护士主导的ED干预措施进行系统审查的需要.
研究的目的:
- 系统地综合证据,以护士为主导的干预对儿科患者ED的有效性.
- 评估这些干预措施对ED发病率和严重程度的影响.
- 为了确定手术前焦虑和术后疼痛的潜在益处.
主要方法:
- 在7个主要数据库中进行全面的文献搜索 (开始至2025年1月).
- 使用ROB2和ROBINS-I工具进行偏差风险评估.
- 对20项涉及2369名儿童的研究 (17个RCT,1个准实验,1个队列) 的元分析,使用Stata 16.0.0.进行.
主要成果:
- 护士主导的干预措施显著降低了ED发生率 (RR:0.50,95% CI:0.33-0.77).
- 观察到m-YPAS (WMD: -7.67),PAED (WMD: -1.47) 和FLACC得分 (WMD: -0.97) 的显著降低.
- 没有发现对PACU停留时间或麻醉诱导遵守的显著影响.
结论:
- 护士主导的干预措施有效地减少了儿童的ED发病率和严重程度.
- 这些干预措施可以缓解手术前的焦虑和术后的疼痛.
- 建议在临床实践中灵活地适应个别儿科患者的需求.
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