老年医源性功能下降预防与管理的证据总结

Summary of the evidence for prevention and management of Hospital-Acquired Functional Decline in the elderly

目的:系统检索、评价并整合老年医源性功能下降的相关证据,为临床医护人员预防并管理老年人医源性功能下降提供循证依据。方法:遵循“6S”模型依次检索计算机决策系统、指南、专业学会网站以及数据库中有关老年医源性功能下降的相关证据,包括指南、临床决策、最佳实践、专家共识、证据总结、系统评价和随机对照试验,检索时限为建库至2024年3月10日。由2名研究者独立进行文献筛选及质量评价,结合主题及专业判断提取证据。结果:共纳入15篇文献,包括1篇临床决策、10篇系统评价、4篇随机对照试验,最终形成评估、风险识别、运动、营养、老年专用病房5个方面18条证据。结论:该研究总结了老年医源性功能下降预防与管理的证据,为临床实践提供了循证依据,医护人员可结合临床情景、证据的促进或阻碍因素以及患者意愿,有针对性地选择证据,尽量避免老年医源性功能下降。

Objective:To systematically search,evaluate,and integrate the relevant evidence on Hospital-Acquired Functional Decline(HAFD)in the elderly to provide evidence-based support for healthcare professionals in preventing and managing HAFD in older adults.Methods:Following the"6S"model,we searched computer decision systems,guidelines,professional society websites,and databases for relevant evidence on age-related decline in geriatric healthcare,including guidelines,clinical decisions,expert consensus,evidence summaries,best practices,and systematic reviews from the database inception to March 10,2024.Two researchers independently performed literature screening and quality assessment,extracted evidence based on themes and professional judgment.Results:A total of 15 articles were included,comprising 1 clinical decisions,10 systematic reviews and 4 randomized controlled trial studies.From the aspects of assessment,risk identification,exercise,nutrition and specialized wards for the elderly,18 pieces of best evidence were summarized.Conclusion:This study provides an evidence-based summary of the best evidence for prevention and management of HAFD in the elderly,offering evidence-based guidance for clinical practice.Healthcare professionals can selectively choose the best evidence based on clinical scenarios,facilitators/barriers identified in the evidence,and patient preferences to minimize hospital acquired functional decline in the elderly.