BI评定量表在非神经系统疾病患者功能状态评估及护理分级确定中应用的范围综述

Barthel Index in assessment of functional status and determination of nursing grading in patients with non-nervous diseases:a review of application scope

目的对BI(Barthel Index)评定量表在非神经系统疾病患者功能状态评估及护理分级确定中应用的相关研究进行范围综述,探讨BI评定量表应用于此类患者功能状态评估时的适用性和在确定该类患者护理分级时的可靠性。方法系统检索9个中文、英文数据库,检索时间为建库至2020年1月。采用范围综述的方法对检索结果进行规范化报告。结果共纳入研究17项,其中7项研究评估非神经系统疾病患者功能状态时的适用性,10项研究评估非神经系统疾病患者护理分级的可靠性。BI评定量表在评估非神经系统疾病患者功能状态时的适用性有局限,在股骨颈骨折患者和老年患者中应用效果存在争议;国内在使用BI评定量表指导护理分级时具有较好的效果。结论BI评定量表并不适用于所有类型疾病患者的功能状态评估,需要结合患者临床实际情况进行判定;另外,据其评分确定分级护理时应谨慎,并关注评估方式、评估时机及其年龄,以便能达到更准确及高效应用该量表进行患者功能评估,并指导护理实践。

Objective To review the literatures on the effect of Barthel Index(BI)in the determination of nursing grading in patients with non-neurological system diseases,therefore to explore the applicability of BI in the assessment of functional status of the patients as well as the reliability in determining the nursing grade.Methods Nine Chinese and English databases from the inception to January 2020 were systematically searched.The scoping review was carried out to analyse and summarise the acquired data.Results A total of 17 studies were included.Seven studies were evaluated in the applicability of the functional status and 10 were evaluated in the reliability of the care grading in the patients with non-nervous diseases.It was found that BI was limited to the application in assessment of the functional status,such as BI remains controversy in the effect of patients with femoral neck fracture and the elderly patients.However,to guide the nursing grading in China,BI has a good effect despite of the lack of quality assessments in the searched studies.Conclusions Barthel Index is not suitable for the evaluation of the functional status of patients with all kinds of diseases.It should be judged on the basis of the actual clinical situations of the patients.In addition,it should be cautious when applying BI in determination of the nursing grading.Important assessment parameters such as the timing of assessment and the age of patients should be considered so that BI could be accurately and efficiently applied in the assessment of the functions of patients,for the purpose of guiding clinical nursing care.