衰弱老年人综合护理干预效果的系统评价

A systematic review of the effects of the comprehensive intervention on frailty in older population

目的系统评价综合护理干预对衰弱老年人的影响。方法计算机检索从2010年1月至2020年12月Cochrane Library、Embase、PubMed、Web of Science、CINAHL、CNKI、中国生物医学文献数据库、万方和维普数据库中公开发表的关于综合护理干预对衰弱老年人影响的随机对照试验。结果共纳入11篇文献,2714例衰弱老年人。Meta分析结果显示,综合护理干预对步速[SMD=0.13,95%CI(0.03,0.22),P=0.007]、Barthel指数[WMD=2.52,95%CI(0.81,4.23),P=0.004]、抑郁[SMD=-0.09,95%CI(-0.18,-0.00),P=0.04]具有积极影响,对衰弱评分[WMD=-0.12,95%CI(-0.43,0.18),P=0.42]、握力[WMD=1.35,95%CI(-0.92,3.61),P=0.24]及生活质量[WMD=-0.42,95%CI(-0.97,0.13),P=0.13]无明显作用。结论综合护理干预可以提高衰弱老年人步速、Barthel指数,改善其抑郁状态,但对衰弱评分、握力和生活质量无明显影响。目前有关综合护理干预对衰弱老年人影响的研究证据尚不充足,且各研究间差异较大,需进行更多高质量的研究以验证其效果。

Objective To identify the effects of the comprehensive intervention on frailty in older population through meta-analysis.Methods Randomized controlled trials on the effectiveness of the comprehensive intervention on frailty of older population were retrieved from the electronic databases of Cochrane Library,PubMed,Embase,Web of Science,CINAHL,CNKI,CBM,Wanfang and VIP from January 2010 to December 2020.Results A total of 11 articles involving 2714 old people were finally included.Meta-analysis results showed that the comprehensive intervention had a positive effect on gait speed[SMD=0.13,95%CI(0.03,0.22),P=0.007],Barthel Index[WMD=2.52,95%CI(0.81,4.23),P=0.004]and depression[SMD=-0.09,95%CI(-0.18,-0.00),P=0.04].The comprehensive intervention had no significant effects on frailty score[WMD=-0.12,95%CI(-0.43,0.18),P=0.42],grip strength[WMD=1.35,95%CI(-0.92,3.61),P=0.24]and quality of life in older population[WMD=-0.42,95%CI(-0.97,0.13),P=0.13].Conclusion The comprehensive intervention significantly improves the gait speed,Barthel Index and depression,but cannot improve frailty score,grip strength and quality of life.At present,the evidence on the effects of the comprehensive intervention on frailty in older population is still insufficient.There are many differences among studies.More high-quality studies are needed to verify the effects of the comprehensive intervention on frailty in older adults.