肠造口患者自我照护的最佳证据总结

Summary of the best evidence for self-care in patients with enterostomy

目的 检索、评价并整合肠造口患者自我照护的最佳证据。方法 采用PIPOST方法确立循证问题,按“6S”金字塔证据模型,系统检索Up To Date、BMJ、JBI、国际指南协作网、医脉通、加拿大安大略省注册护士协会、美国伤口造口失禁护士协会、Cochrane Library、PubMed、Ovid、CINAHL、中国知网(CNKI)和万方等数据库中关于肠造口患者自我照护措施相关的临床决策、指南、系统评价、专家共识和原始研究等,检索时限为建库至2023年5月2日。结果 共纳入14篇文献,其中临床决策1篇、指南5篇、专家共识2篇、系统评价3篇、随机对照试验3篇,从自我照护目标、自我照护前准备、自我照护措施及促进策略4个维度,共汇总出35条证据。结论 本研究总结形成了肠造口患者自我照护的最佳证据,在心理调节、学习知识、造口照护、用药管理、饮食营养、身体活动、生活方式和自我监测方面规范肠造口患者自我照护行为,给予自我照护指导提供参考依据,建议在临床实践时,可结合临床情景及患者意愿选择适合的证据应用。

Objective To retrieve,evaluate,and integrate the best evidenceof self-care in patients with enterostomy.Methods The evidence-based problems were constructed according to the PIPOST model,and according to the"6S"evidence model,UpToDate,BMJ,JBI,International Guideline Collaboration Network,Yimaitong,Registered Nurses Association of Ontario of Canada,American Association of Incontinence Nurses,Cochrane Library,PubMed,Ovid,CINAHL,CNKI,Wanfang and other databases were searched for clinical decisions,guidelines,systematic reviews,expert consensuses,and original studies related to self-care measures for patients with enterostomy,and the retrieval time limit was from the establishment of the database to May 2,2023.Results A total of 14 articles were included,including 1 clinical decision-making,5 guidelines,2 expert consensuses,3 systematic reviews,and 3 randomized controlled trials.A total of 35 pieces of evidence were summarized from 4 dimensions of self-care goals,self-care preparation,self-care measures,and promotion strategies.Conclusion This study summarized and formed the best evidence of self-care for patients with enterostomy.In terms of psychological adjustment,learning knowledge,stoma care,medication management,diet and nutrition,physical activity,lifestyle and self-monitoring,this study standardized the self-care behavior of patients with enterostomy and provided reference for self-care guidance.It is suggested that in clinical practice,appropriate evidence application can be selected according to clinical situation and patient's wishes.