老年人衰弱筛查和评估的证据总结

发布时间：2018-01-02 20:31

本文关键词：老年人衰弱筛查和评估的证据总结　出处：《护理学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的评价和总结老年人衰弱筛查和评估的最佳证据,为老年人衰弱筛查提供参考。方法计算机检索Cochrane Library、EBM reviews、PubMed、ClinicalKey、英国老年医学会、美国老年医学会、英国国家临床医学研究所指南网、万方数据库、中国知网及中国生物医学文献数据库有关老年人衰弱筛查和评估的指南、系统评价及实践报告,由2名经过循证培训的研究人员分别对文献质量进行评价和资料提取,对符合要求的文献进行证据提取。结果共纳入7篇文献,其中2篇指南、1篇专家共识、2篇系统评价和2篇诊断性研究。得到的最佳证据:1互动的临床情境下需对老年人进行衰弱评估(B级推荐);2识别出衰弱后,需由经过培训的专业人员对老年人进行全面评估(A级推荐);3躯体功能、步速和认知功能是最常用来识别衰弱的指标,其次是体质量下降、日常生活能力和营养状况(A级推荐);4步速、起立-行走试验和PRISMA适用于与老年人接触时的任何情境下的衰弱筛查(A级推荐);5Tilburg衰弱评估量表和格罗宁根衰弱指标具有较好的内部一致性,且两者的一致性较好,但他们是否适合用于筛查衰弱仍需进一步数据支持(B级推荐);6埃德蒙特衰弱量表简便易评,可供非老年专科医生使用,且在门诊和病房的应用效果都较为满意(B级推荐)。结论建议对接触的老年人进行衰弱筛查,但尚没有权威统一的工具,步速、起立-行走试验和PRISMA较为敏感,可用于筛查,对筛查结果为衰弱的老年人应进一步进行全面评估。
[Abstract]:Objective to evaluate and summarize the best evidence for the screening and evaluation of senile debilitating, and to provide a reference for the screening of senile debilitating. Methods Cochrane Library was searched by computer. EBM Review of PubMedus ClinicalKey. British Association of Geriatrics, American Association of Geriatrics, National Institute of Clinical Medicine Guide Network, Wanfang Database. Guide, systematic evaluation and practice report on the screening and assessment of senile debilitating in China knowledge Network and Chinese Biomedical Literature Database. Two Evidence-based training researchers evaluated the quality of the literature and extracted the data, and extracted the evidence from the required literature. The results were included in 7 articles, of which 2 guidelines and 1 expert consensus. Two systematic reviews and two diagnostic studies. The best evidence obtained is that the elderly should be evaluated for debilitating in the clinical context of the interaction of 1: 1. (2) after the weakness has been identified, it is necessary to make a comprehensive assessment of the elderly by trained professionals. (3) somatic function, step speed and cognitive function were the most commonly used indexes to identify weakness, followed by body mass decline, daily life ability and nutritional status. 4 step speed, standing-up-walking test and PRISMA were suitable for the screening of debilitating patients in any situation when they were in contact with the elderly. 5Tilburg debilitating evaluation scale and Groningen debilitating index had good internal consistency and good consistency. But whether they are suitable for screening for debilitating needs further data to support the B level recommendation; 6 Edmont debilitating scale is simple and easy to evaluate, and can be used by non-elderly specialists, and the application effect in outpatient department and ward is satisfactory. Conclusion it is recommended that the elderly exposed to debilitating screening should be screened. But there is no authoritative uniform tool, step speed, standing-walk test and PRISMA are more sensitive, can be used for screening, screening results for the elderly should be further comprehensive assessment.
【作者单位】：北京协和医学院护理学院;北京协和医院老年示范病房;
【分类号】：R472
【正文快照】： 衰弱是由多种原因引起的,以力量和耐力下降、生理功能减退为特点,个体对依赖和死亡的易感性增加的一种医学综合征[1-2]。衰弱在老年人中较为普遍存在,国外报道其在65岁以上老年人中的发生率为4.0%~27.8%[3-8],在80岁以上老年人中更是高达20.0%~45.1%[9-11]。国内尚无大型流行

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