PDF(Pubmed)
Abstract：
BACKGROUND: Post-operative cognitive dysfunction (POCD) is a concern for clinicians that often presents post-surgery where generalized anesthesia has been used. Its prevalence ranges from 36.6% in young adults to 42.4% in older individuals. Conceptual clarity for POCD is lacking in the currently body literature. Our two-fold purpose of this concept analysis was to (1) critically appraise the various definitions, while also providing the best definition, of POCD and (2) narratively synthesize the attributes, surrogate or related terms, antecedents (risk factors), and consequences of the concept.
METHODS: The reporting of our review was guided by the PRISMA statement and the 6-step evolutionary approach to concept analysis developed by Rodgers. Three databases, including Medline, CINAHL, and Web of Science, were searched to retrieve relevant literature on the concept of POCD. Two independent reviewers conducted abstract and full-text screening, data extraction, and appraisal. The review process yielded a final set of 86 eligible articles.
RESULTS: POCD was defined with varying severities ranging from subtle-to-extensive cognitive changes (1) affecting single or multiple cognitive domains that manifest following major surgery (2), is transient and reversible, and (3) may last for several weeks to years. The consequences of POCD may include impaired quality of life, resulting from withdrawal from the labor force, increased patients\' dependencies, cognitive decline, an elevated risk of dementia, rising healthcare costs, and eventual mortality.
CONCLUSIONS: This review resulted in a refined definition and comprehensive analysis of POCD that can be useful to both researchers and clinicians. Future research is needed to refine the operational definitions of POCD so that they better represent the defining attributes of the concept.
METHODS: The reporting of our review was guided by the PRISMA statement and the 6-step evolutionary approach to concept analysis developed by Rodgers. Three databases, including Medline, CINAHL, and Web of Science, were searched to retrieve relevant literature on the concept of POCD. Two independent reviewers conducted abstract and full-text screening, data extraction, and appraisal. The review process yielded a final set of 86 eligible articles.
RESULTS: POCD was defined with varying severities ranging from subtle-to-extensive cognitive changes (1) affecting single or multiple cognitive domains that manifest following major surgery (2), is transient and reversible, and (3) may last for several weeks to years. The consequences of POCD may include impaired quality of life, resulting from withdrawal from the labor force, increased patients\' dependencies, cognitive decline, an elevated risk of dementia, rising healthcare costs, and eventual mortality.
CONCLUSIONS: This review resulted in a refined definition and comprehensive analysis of POCD that can be useful to both researchers and clinicians. Future research is needed to refine the operational definitions of POCD so that they better represent the defining attributes of the concept.
摘要：
背景：手术后认知功能障碍（POCD）是临床医生关注的问题，通常会出现全身麻醉的手术后。其患病率从年轻人的36.6%到老年人的42.4%不等。当前的身体文献中缺乏POCD的概念清晰度。我们这个概念分析的双重目的是(1)批判性地评估各种定义，同时也提供了最好的定义，POCD和(2)叙述地综合了属性，代理或相关术语，前因(风险因素)，以及概念的后果。
方法：我们的综述报告以PRISMA声明和Rodgers开发的概念分析的6步进化方法为指导。三个数据库,包括Medline,CINAHL,和WebofScience,检索有关POCD概念的相关文献。两名独立审稿人进行了摘要和全文筛选,数据提取,和评估。审查过程产生了最终的86篇合格文章。
结果：POCD的定义具有不同的严重程度，从细微到广泛的认知变化（1）影响大手术后表现出的单个或多个认知领域（2），是瞬态和可逆的，和（3）可能持续数周至数年。POCD的后果可能包括生活质量受损，由于退出劳动力大军，增加了患者的依赖性，认知能力下降,痴呆症的风险增加，医疗费用上涨,和最终的死亡率。
结论：这篇综述导致了对POCD的精确定义和全面分析，对研究人员和临床医生都有用。需要进一步的研究来完善POCD的操作定义，以便它们更好地表示概念的定义属性。
方法：我们的综述报告以PRISMA声明和Rodgers开发的概念分析的6步进化方法为指导。三个数据库,包括Medline,CINAHL,和WebofScience,检索有关POCD概念的相关文献。两名独立审稿人进行了摘要和全文筛选,数据提取,和评估。审查过程产生了最终的86篇合格文章。
结果：POCD的定义具有不同的严重程度，从细微到广泛的认知变化（1）影响大手术后表现出的单个或多个认知领域（2），是瞬态和可逆的，和（3）可能持续数周至数年。POCD的后果可能包括生活质量受损，由于退出劳动力大军，增加了患者的依赖性，认知能力下降,痴呆症的风险增加，医疗费用上涨,和最终的死亡率。
结论：这篇综述导致了对POCD的精确定义和全面分析，对研究人员和临床医生都有用。需要进一步的研究来完善POCD的操作定义，以便它们更好地表示概念的定义属性。
