摘要
目的评价痴呆老人精神行为问题非药物管理相关循证指南,为更好地管理痴呆老人的精神行为问题提供参考。方法计算机检索文献数据库和国内外指南网站、医学会网站,搜集痴呆老人精神行为问题非药物管理相关循证指南,检索时限均为建库至2016年5月31日。采用临床研究与评估工具(AGREE II)对纳入的指南进行质量评价,汇总各指南的推荐意见并比较其异同。结果初步检索到544篇原始文献,最终纳入的6部相关指南均来自国外,6部指南AGREE II评价的平均得分分别为范围和目的 88.89%、参与人员65.74%、严谨性63.72%、清晰性86.11%、应用性50.69%和独立性37.50%,指南总体质量评价均为B级。各指南的推荐意见基本一致,主要推荐的非药物管理措施包括休闲娱乐活动、怀旧疗法、行为疗法、照顾者培训、环境设置、宠物疗法、按摩疗法、躯体锻炼及个性化护理。结论纳入的痴呆老人精神行为问题非药物管理指南总体质量较高,完善指南的应用性和独立性领域后会更适用;应尽快开发适用于我国的痴呆老人精神行为问题非药物管理相关指南。
Objective To systematically review the methodological quality of evidence-based guidelines on non-pharmacology management of behavioral and psychological symptoms of dementia, so as to provide references for taking caring for the dementia with behavioral and psychological symptoms. Methods Guidelines concerning non-pharmacology treatment of behavioral and psychological symptoms were searched from websites of guideline development, websites of medical association and literature databases from inception to May 31st 2016. The methodological quality of included guidelines were evaluated according to the AGREE II instrument, and the differences and similarities between recommendations of included guidelines were compared. Results A total of 544 literatures were identified and 6 of them were included. All the included guidelines were from abroad. The average scores of guidelines in six domains of AGREE II were： scope and purpose 88.89%, stakeholder involvement 65.74%, rigor of development 63.72%, clarity of presentations 86.11%, applicability 50.69%, and independence 37.50%. The overall qualities of the included guidelines were grade B. The recommendations of the included guidelines were almost consistent. Recommended non- pharmacology management of behavioral and psychological symptoms of dementia included leisure and recreation activity, reminiscence therapy, behavioral therapy, training of caregivers, physical environment modification, animal- assisted therapy, massage, physical activity and patient-centered approach. Conclusion The overall quality of included guidelines is relativdy high. More efforts are needed to improve the applicability and independence of guidelines. There is still no local guideline concerning non-pharmacology recommendations on behavioral and psychological symptoms of dementia in China. It is suggested to develop guideline that is suitable for Chinese condition as soon as possible.
出处
《中国循证医学杂志》
CSCD
2016年第11期1338-1344,共7页
Chinese Journal of Evidence-based Medicine
基金
教育部人文社会科学研究青年基金(编号:13YJCZHl90)
北京大学医学部护理科研基金(编号:BMU20160522)
关键词
痴呆
精神行为
指南
系统评价
临床研究与评估工具
Dementia
Behavioral and psychological symptoms
Guideline
Systematic review
AGREE II
