帕金森病患者跌倒预防的最佳证据总结

Evidence summary of falling prevention in patients with Parkinson’s disease

目的评价并总结帕金森病患者跌倒预防的相关证据,为临床医护人员预防帕金森病患者跌倒提供借鉴。方法系统检索国内外相关数据库及帕金森病专业学术网站中关于预防帕金森病患者跌倒的临床决策、指南、证据总结、系统评价、专家共识,检索时限为建库至2021年8月31日,对纳入文献进行方法学质量评价,根据主题对证据进行提取与汇总。结果共纳入18篇文献,包括2篇临床决策、2篇指南、1篇证据总结、12篇系统评价、1篇专家共识。结合专业人员的判断,从评估与监测、日常安全管理、运动管理、营养支持及教育培训5个方面进行了证据总结,形成24条最佳证据。结论该研究全面、科学地总结了帕金森病患者跌倒预防的最佳证据,证据使用者在证据转化过程中应考虑具体情境,针对性地选择证据,以便制订符合个体情况的本土化的帕金森病患者跌倒预防管理方案,降低其跌倒发生风险,提升照护质量。

Objective To evaluate and summarize the relevant evidence of falling prevention in patients with Parkinson’s disease,in order to provide references for clinical medical staff.Methods The evidence-based nursing method was used to systematically retrieve the clinical decisions,guidelines,evidence summaries,systematic evaluations and expert consensuses on the prevention of falls in patients with Parkinson’s disease in relevant databases at home and abroad and professional academic websites of Parkinson’s disease.The retrieval time limit was from the establishment of the databases to August 31,2021.After the methodological quality evaluation,the evidence was extracted and summarized according to the subject.Results A total of 18 pieces of the literature were involved,including 2 clinical decisions,2 guidelines,1 evidence summary,12 systematic reviews and 1 expert consensus.Combined with the judgment of professionals,the evidence was summarized from 5 aspects:evaluation and monitoring,daily safety management,sports management,nutritional support and education and training,and 24pieces of best evidence were formed.Conclusion This study comprehensively and scientifically summarizes the best evidence of fall prevention and management plan for patients with Parkinson’s disease.In the process of evidence transformation,evidence users should consider specific situations,pertinently select the evidence,formulate the individualized fall prevention and management plan for patients with Parkinson’s disease,reduce the risk of falls and improve the quality of care.