失能老人家庭病床智慧管理研究的范围综述

Smart management of hospital-at-home services for disabled older people:a scoping review

目的对失能老人家庭病床智慧管理研究进行范围综述,为相关研究与干预提供参考。方法以主题词和自由词相结合的方式检索PubMed、Web of Science、中国知网、万方数据等国内外数据库中相关研究,检索时限为建库至2022年6月30日,对纳入文献进行提取与分析。结果纳入8篇文献,智慧管理方案包括移动医疗和远程保健2种形式;内容要素涵盖临床诊疗、建立患者健康档案、设备使用指导、警报管理;策略要素涵盖组建多学科团队、明确团队成员职责、入床前综合评估、全程动态等级评估;评价要素主要包括患者健康结局、智慧医疗依赖性、患者满意度评价、管理方案依从性和可行性。结论失能老人家庭病床智慧管理研究呈现多样性、有效性;缺乏规范统一的管理评价标准及高质量研究数据。需加强多中心、大样本、高质量研究,以提供高水平证据。

Objective To conduct a scoping review of research on smart management of hospital-at-home services for disabled older people,and to provide references for future studies and interventions.Methods Relevant studies in domestic and international databases such as PubMed,Web of Science,China Knowledge Network,and Wanfang Data were searched by utilizing Mesh terms and free-text terms,and the search time frame was set from establishment of the database to June 30,2022.Results Eight publications met the inclusion criteria.There were two types of smart hospital-at-home services:mobile health and telehealth.Services included clinical treatment,establishment of patient health records,guidance on device use,and alarm management.Strategies included building multidisciplinary teams,clarifying team members′responsibilities,comprehensive assessment before entering hospital-at-home services,and dynamic grade assessment throughout the process.Evaluation indexes included patient outcomes,dependency on smart devices,patient satisfaction,compliance with and feasibility of the management program.Conclusion Research on smart home care for disabled older people has demonstrated diversity and effectiveness,however,there are lack of standardized and unified evaluation criteria and high-quality research data.Multi-center,large sample,and high-quality studies need to be strengthened to provide high-level evidence.