PDF(Pubmed)
Abstract：
BACKGROUND: Delirium is a neuropathological syndrome that is characterised by fluctuating impairments in attention, cognitive performance, and consciousness. Since delirium represents a medical emergency, it can be associated with adverse clinical and economic outcomes. Although nursing home residents face a high risk of developing delirium, health care professionals in this field appear to have limited knowledge of delirium despite the critical role they play in the prevention, diagnosis, and treatment of delirium in nursing homes.
OBJECTIVE: The purpose of this realist review is to develop an initial programme theory with the goal of understanding how, why, and under what circumstances educational interventions can improve the delirium-specific knowledge of health care professionals in nursing homes.
METHODS: This realist review was conducted in accordance with the RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines and includes the following steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis; and (5) development of an initial programme theory. It also included stakeholder discussions with health care professionals recruited from nursing home care, which focused on their experiences with delirium.
RESULTS: From a set of 1703 initially identified publications, ten publications were included in this realist review. Based on these publications, context-mechanism-outcome configurations were developed; these configurations pertained to (1) management support, (2) cognitive impairments among residents, (3) familiarity with residents, (4) participatory intervention development, (5) practical application, (6) case scenarios, (7) support from experts and (8) relevance of communication.
CONCLUSIONS: Educational interventions aimed at improving the delirium-specific knowledge of health care professionals should feature methodological diversity if they are to enhance health care professionals\' interest in delirium and highlight the fundamental contributions they make to the prevention, diagnosis, and treatment of delirium. Educational interventions should also take into account the multidimensional contextual factors that can have massive impacts on the relevant mode of action as well as the responses of health care professionals in nursing homes. The identification of delirium in residents is a fundamental responsibility for nursing home staff.
BACKGROUND: This review has been registered at Open Science Framework https://doi.org/10.17605/OSF.IO/6ZKM3.
OBJECTIVE: The purpose of this realist review is to develop an initial programme theory with the goal of understanding how, why, and under what circumstances educational interventions can improve the delirium-specific knowledge of health care professionals in nursing homes.
METHODS: This realist review was conducted in accordance with the RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines and includes the following steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis; and (5) development of an initial programme theory. It also included stakeholder discussions with health care professionals recruited from nursing home care, which focused on their experiences with delirium.
RESULTS: From a set of 1703 initially identified publications, ten publications were included in this realist review. Based on these publications, context-mechanism-outcome configurations were developed; these configurations pertained to (1) management support, (2) cognitive impairments among residents, (3) familiarity with residents, (4) participatory intervention development, (5) practical application, (6) case scenarios, (7) support from experts and (8) relevance of communication.
CONCLUSIONS: Educational interventions aimed at improving the delirium-specific knowledge of health care professionals should feature methodological diversity if they are to enhance health care professionals\' interest in delirium and highlight the fundamental contributions they make to the prevention, diagnosis, and treatment of delirium. Educational interventions should also take into account the multidimensional contextual factors that can have massive impacts on the relevant mode of action as well as the responses of health care professionals in nursing homes. The identification of delirium in residents is a fundamental responsibility for nursing home staff.
BACKGROUND: This review has been registered at Open Science Framework https://doi.org/10.17605/OSF.IO/6ZKM3.
摘要：
背景：谵妄是一种神经病理学综合征，其特征是注意力波动，认知表现，和意识。由于谵妄代表医疗紧急情况，它可能与不良临床和经济结果相关.尽管疗养院居民面临发生谵妄的高风险，这一领域的卫生保健专业人员似乎对谵妄的知识有限，尽管他们在预防中发挥着关键作用，诊断,疗养院谵妄的治疗。
目的：这篇现实主义综述的目的是发展一个初步的计划理论，目的是了解如何，为什么,以及在什么情况下教育干预可以提高疗养院卫生保健专业人员的谵妄知识。
方法：此现实主义综述是根据RAMESES（现实主义和元叙事证据综合：和不断发展的标准）指南进行的，包括以下步骤：（1）搜索策略和文献综述；（2）研究选择和评估；（3）数据提取；（4）数据综合；（5）开发初始程序理论。它还包括利益相关者与从养老院护理招募的医疗保健专业人员的讨论，专注于他们的谵妄经历。
结果：从最初确定的1703种出版物中，这份现实主义评论中包括了十份出版物。根据这些出版物，开发了上下文-机制-结果配置；这些配置与(1)管理支持，(2)居民认知障碍，（3）熟悉居民，(4)参与式干预发展,（5）实际应用，(6)案例场景，（7）专家的支持和（8）沟通的相关性。
结论：旨在提高卫生保健专业人员谵妄知识的教育干预措施，如果要提高卫生保健专业人员对谵妄的兴趣，并强调其对谵妄的基本贡献，则应具有方法多样性。预防诊断,和谵妄的治疗。教育干预还应考虑到可能对相关行动模式产生巨大影响的多维背景因素以及疗养院卫生保健专业人员的反应。居民谵妄的识别是养老院工作人员的基本责任。
背景：此评论已在OpenScienceFrameworkhttps://doi.org/10.17605/OSF上注册。IO/6ZKM3。
目的：这篇现实主义综述的目的是发展一个初步的计划理论，目的是了解如何，为什么,以及在什么情况下教育干预可以提高疗养院卫生保健专业人员的谵妄知识。
方法：此现实主义综述是根据RAMESES（现实主义和元叙事证据综合：和不断发展的标准）指南进行的，包括以下步骤：（1）搜索策略和文献综述；（2）研究选择和评估；（3）数据提取；（4）数据综合；（5）开发初始程序理论。它还包括利益相关者与从养老院护理招募的医疗保健专业人员的讨论，专注于他们的谵妄经历。
结果：从最初确定的1703种出版物中，这份现实主义评论中包括了十份出版物。根据这些出版物，开发了上下文-机制-结果配置；这些配置与(1)管理支持，(2)居民认知障碍，（3）熟悉居民，(4)参与式干预发展,（5）实际应用，(6)案例场景，（7）专家的支持和（8）沟通的相关性。
结论：旨在提高卫生保健专业人员谵妄知识的教育干预措施，如果要提高卫生保健专业人员对谵妄的兴趣，并强调其对谵妄的基本贡献，则应具有方法多样性。预防诊断,和谵妄的治疗。教育干预还应考虑到可能对相关行动模式产生巨大影响的多维背景因素以及疗养院卫生保健专业人员的反应。居民谵妄的识别是养老院工作人员的基本责任。
背景：此评论已在OpenScienceFrameworkhttps://doi.org/10.17605/OSF上注册。IO/6ZKM3。
