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Abstract：
BACKGROUND: Frailty reduction and reversal have been addressed successfully among older populations within community settings. However, these findings may not be applicable to residential care settings, largely due to the complex and multidimensional nature of the condition. Relatively, few attempts at frailty prevention exist in residential settings. This review aims to identify and describe best practice models of care for addressing frailty among older populations in residential care settings. This research also sets out to explore the impact of multidisciplinary health service delivery models on health outcomes such as mortality, hospitalisations, quality of life, falls and frailty.
METHODS: A scoping review of the literature was conducted to address the project objectives. Reference lists of included studies, bibliographic databases and the grey literature were systematically searched for literature reporting multidisciplinary, multidimensional models of care for frailty.
RESULTS: The scoping review found no interventions that met the inclusion criteria. Of the 704 articles screened, 664 were excluded as not relevant. Forty articles were fully assessed, and while no eligible studies were found, relevant data were extracted from 10 near-eligible studies that reported single disciplines or single dimensions rather than a model of care. The physical, nutritional, medicinal, social and cognitive aspects of the near eligible studies have been discussed as playing a key role in frailty reduction or prevention care models.
CONCLUSIONS: This review has identified a paucity of interventions for addressing and reducing frailty in residential care settings. High-quality studies investigating novel models of care for addressing frailty in residential care facilities are required to address this knowledge gap. Similarly, there is a need to develop and validate appropriate screening and assessment tools for frailty in residential care populations. Health service providers and policy-makers should also increase their awareness of frailty as a dynamic and reversible condition. While age is a non-modifiable predictor of frailty, addressing modifiable factors through comprehensive care models may help manage and prevent the physical, social and financial impacts of frailty in the ageing population.
METHODS: A scoping review of the literature was conducted to address the project objectives. Reference lists of included studies, bibliographic databases and the grey literature were systematically searched for literature reporting multidisciplinary, multidimensional models of care for frailty.
RESULTS: The scoping review found no interventions that met the inclusion criteria. Of the 704 articles screened, 664 were excluded as not relevant. Forty articles were fully assessed, and while no eligible studies were found, relevant data were extracted from 10 near-eligible studies that reported single disciplines or single dimensions rather than a model of care. The physical, nutritional, medicinal, social and cognitive aspects of the near eligible studies have been discussed as playing a key role in frailty reduction or prevention care models.
CONCLUSIONS: This review has identified a paucity of interventions for addressing and reducing frailty in residential care settings. High-quality studies investigating novel models of care for addressing frailty in residential care facilities are required to address this knowledge gap. Similarly, there is a need to develop and validate appropriate screening and assessment tools for frailty in residential care populations. Health service providers and policy-makers should also increase their awareness of frailty as a dynamic and reversible condition. While age is a non-modifiable predictor of frailty, addressing modifiable factors through comprehensive care models may help manage and prevent the physical, social and financial impacts of frailty in the ageing population.
摘要：
背景：在社区环境中，老年人群的衰弱减少和逆转已得到成功解决。然而,这些发现可能不适用于住宅护理环境，很大程度上是由于条件的复杂性和多维性。相对而言,在住宅环境中，很少有预防脆弱的尝试。这篇综述旨在确定和描述解决住宿护理环境中老年人群虚弱问题的最佳护理实践模式。这项研究还探讨了多学科卫生服务提供模式对健康结果的影响，如死亡率，住院治疗,生活质量,跌倒和虚弱。
方法：对文献进行范围审查以解决项目目标。纳入研究的参考清单，系统搜索书目数据库和灰色文献，寻找报告多学科的文献，脆弱护理的多维模型。
结果：范围审查未发现符合纳入标准的干预措施。在筛选的704篇文章中，664人被排除为不相关。40篇文章得到了充分评估，虽然没有找到合格的研究，相关数据来自10项接近符合条件的研究,这些研究报告单学科或单维度,而非护理模型.物理，营养,药用,已经讨论了接近符合条件的研究的社会和认知方面，这些研究在减少虚弱或预防护理模式中起着关键作用。
结论：本综述发现，解决和减少住宅护理环境中的虚弱的干预措施很少。为了解决这一知识差距，需要进行高质量的研究，以研究解决住宅护理设施中脆弱的新型护理模式。同样，有必要开发和验证适当的筛查和评估工具，以预防住院护理人群的脆弱性。卫生服务提供者和政策制定者还应提高对脆弱作为一种动态和可逆状况的认识。虽然年龄是虚弱的不可修改的预测指标，通过全面的护理模式解决可改变的因素可能有助于管理和预防身体，人口老龄化的脆弱对社会和金融的影响。
方法：对文献进行范围审查以解决项目目标。纳入研究的参考清单，系统搜索书目数据库和灰色文献，寻找报告多学科的文献，脆弱护理的多维模型。
结果：范围审查未发现符合纳入标准的干预措施。在筛选的704篇文章中，664人被排除为不相关。40篇文章得到了充分评估，虽然没有找到合格的研究，相关数据来自10项接近符合条件的研究,这些研究报告单学科或单维度,而非护理模型.物理，营养,药用,已经讨论了接近符合条件的研究的社会和认知方面，这些研究在减少虚弱或预防护理模式中起着关键作用。
结论：本综述发现，解决和减少住宅护理环境中的虚弱的干预措施很少。为了解决这一知识差距，需要进行高质量的研究，以研究解决住宅护理设施中脆弱的新型护理模式。同样，有必要开发和验证适当的筛查和评估工具，以预防住院护理人群的脆弱性。卫生服务提供者和政策制定者还应提高对脆弱作为一种动态和可逆状况的认识。虽然年龄是虚弱的不可修改的预测指标，通过全面的护理模式解决可改变的因素可能有助于管理和预防身体，人口老龄化的脆弱对社会和金融的影响。
