背景:身体约束已被视为重症监护病房(ICU)中的一种保护措施,以避免意外事件。但大量的研究已经证明,身体约束会对患者的心理健康造成不良影响,比如孩子的语言延迟,不确定感,失去信任,等。然而,目前尚不清楚目前是否有高质量的临床实践指南(CPG)来指导身体约束的临床实践.因此,我们旨在通过评估研究与评估指南II(AGREEII)评估方法质量和评估医疗实践指南(RIGHT)评估报告质量的报告项目来分析ICU中有关身体约束的可用CPG。
方法:我们系统地搜索了PubMed,Embase,WebofScience,CINAHL,CNKI(中文数据库),万方数据(中文数据库),相关网站(GIN,Nice,SIGN,RNAO,AHRQ,AACN),和谷歌从成立到2021年11月21日。两名审阅者独立使用AGREEII工具和RIGHT清单来评估ICU中有关身体约束的指南的方法学和报告质量。计算了RIGHT清单报告项目的数量和比例以及AGREEII每个领域的得分。我们还通过使用组内相关系数评估了审阅者之间的一致性。
结果:共纳入6个指南。纳入指南的平均AGREEII评分为39.56%,范围为30.27-69.85%。没有准则是“高质量”,只有一个指南是“中等质量”,平均AGREEII评分为69.85%。指南的平均RIGHT报告评分为41.0%,范围为24.7-77.7%。只有一个指南是“中度报告”,平均报告评分为77.7%。
结论:一般来说,身体约束指南的方法和报告质量较低,未来需要制定或更新高质量的指南来指导临床实践。
BACKGROUND: Physical restraint has been regarded as a protective measure in the intensive care unit (ICU) in order to avoid unexpected events. But a great number of researches have proven that physical restraints can cause bad influences on patients\' mental health, such as language delays of children, sense of uncertainty, loss of trust, etc. However, it is unclear whether there are currently high-quality clinical practice guidelines (CPGs) to guide clinical practice in physical restraints. So we aim to analyze available CPGs on physical restraints in ICU with Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluating methodological quality and Reporting Items for Practice Guidelines in Healthcare (RIGHT) evaluating reporting quality.
METHODS: We systematically searched PubMed, Embase, Web of Science, CINAHL, CNKI (Chinese database), Wanfang data (Chinese database), relevant websites (GIN, NICE, SIGN, RNAO, AHRQ, AACN), and Google from their inception to Nov 21, 2021. Two reviewers independently use the AGREE II tool and RIGHT checklist to evaluate methodological and reporting quality of included guidelines on physical restraints in ICU. The number and proportion of reported items of RIGHT checklist and the scores of each domain of AGREE II were calculated. We also evaluated the consistency among the reviewers via use of the intragroup correlation coefficient.
RESULTS: A total of six guidelines were included. The mean AGREE II score for the included guidelines was 39.56% with a range of 30.27-69.85%. No guideline was \"high quality\", and only one guideline was \"moderate quality\" with 69.85% mean AGREE II score. The mean RIGHT reporting score for guidelines was 41.0% with a range of 24.7-77.7%. Only one guideline was \"moderate-reported\" with a mean reporting score of 77.7%.
CONCLUSIONS: In general, the methodological and reporting quality of physical restraints guidelines is low, and future development or updating of high-quality guidelines to guide clinical practice is needed.