背景:谵妄是住院期间的常见病,应加以预防和治疗。迄今为止,已经提出了几项建议,而很少有研究调查它们在医疗和急性后环境的日常实践中的适用性。
目的:本研究的目的是提出研究建议的干预措施在医疗和急性后护理高危患者或谵妄患者的日常护理中的适用性。
方法:本研究分三个阶段进行。根据审查和传播中心进行了系统的文献综述(2021年1月至2月)。科克伦图书馆,Pubmed,Scopus,护理和相关健康文献的累积指数,心理信息数据库,搜索了JoannaBriggs研究所的数据库.使用标准质量评估标准评估初级和次级研究的方法学质量,关键评估技能计划,以及对研究与评估指南的评估。然后,使用NominalGroup技术对所确定的干预措施的适用性进行评估,该技术在4分Likert量表上对其判断从1(完全不适用)到4(完全适用)进行排名.还考虑了定性反馈,最终列表的验证由标称组进行。
结果:共纳入12项研究,列出了96种干预措施,分为四个宏观领域(预防,非药理学,沟通和药理管理)。名义组确定了51种适用于医疗和急性后环境的干预措施(平均评分>3.5)。然后,通过重新阅读的过程,并根据名义组提供的意见进行修改,在最初的96项干预措施中,有35项干预措施被判定为适用.
结论:应与领域专家一起评估适用性,以了解相关因素。三分之一的干预措施被认为在意大利适用;护士的专业知识,工作环境特点,并且在高工作量环境中每次干预所需的时间可能会阻止文献建议的干预措施的完全适用性。
BACKGROUND: Delirium is a common condition during hospitalisation that should be prevented and treated. Several recommendations have been established to date, whereas few studies have investigated their
applicability in daily practice for medical and post-acute settings.
OBJECTIVE: The aim of this research exercise was to emerge the
applicability of the interventions recommended by studies in the daily care of patients at risk or with delirium cared in medical and post-acute settings.
METHODS: The study was organised in three phases. A systematic literature
review according to Centre for Reviews and Dissemination was conducted (January-February 2021). Cochrane Library, Pubmed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Psychological Information Database, and the Joanna Briggs Institute databases were searched. Primary and secondary studies were evaluated in their methodological quality with the Standard Quality Assessment Criteria, the Critical Appraisal Skills Programme, and the Appraisal of Guidelines for Research & Evaluation. Then, the interventions identified were assessed in their
applicability using the Nominal Group Technique who ranked their judgement on a four-point Likert scale from 1 (totally inapplicable) to 4 (totally applicable). Qualitative feedbacks were also considered, and a validation of the final list was performed by the Nominal Group.
RESULTS: A total of 12 studies were included producing a list of 96 interventions categorised into four macro-areas (prevention, non-pharmacological, communication and pharmacological management). The Nominal Group identified 51 interventions (average score > 3.5) as applicable in medical and post-acute settings. Then, through a process of re-reading, and revising according to the comments provided by the Nominal Group, a list of 35 interventions out of the initial 96 were judged as applicable.
CONCLUSIONS: Applicability should be assessed with experts in the field to understand the involved factors. One-third of interventions have been judged as applicable in the Italian context; the nurses\' expertise, the work environment features, and the time required for each intervention in a high workload setting may prevent the full applicability of the interventions recommended by the literature.