目的基于循证方法总结ICU气管插管患者拔管后吞咽障碍(PED)康复护理最佳证据。方法遵照“6S”证据检索模型,检索BMJ Best Practice、UpToDate、国际指南协作网(GIN)、英国国家卫生与临床优化研究所(NICE)网站、苏格兰学院间指南网(SIGN...目的基于循证方法总结ICU气管插管患者拔管后吞咽障碍(PED)康复护理最佳证据。方法遵照“6S”证据检索模型,检索BMJ Best Practice、UpToDate、国际指南协作网(GIN)、英国国家卫生与临床优化研究所(NICE)网站、苏格兰学院间指南网(SIGN)、美国国立指南网(NGC)、医脉通网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心网站、PubMed、Embase、卫生保健及护理学数据库(CINAHL)、中国知网、中国生物医学文献数据库、万方数据知识服务平台中有关ICU气管插管患者PED康复护理相关研究,检索时间为建库至2023年9月。由2名研究人员独立进行文献筛选及资料提取、文献质量评价。结果最终纳入文献12篇,包括专家共识5篇、系统评价4篇、指南2篇、临床决策1篇。最终形成了ICU气管插管患者PED康复护理最佳证据,其包括人员筹备、筛查与评估、基础训练、代偿训练、并发症管理、口腔护理、教育与培训7个类别共32条证据,各证据的等级为1a~5b级,推荐级别为A~B级。结论本研究基于循证方法总结了ICU气管插管患者PED康复护理最佳证据,包括人员筹备、筛查与评估、基础训练、代偿训练、并发症管理、口腔护理、教育与培训7个类别共32条证据。展开更多
AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis(OA). METHODS: We hand searched meta-analyses o...AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis(OA). METHODS: We hand searched meta-analyses on the topic published in 2010 and updated the search in three electronic databases(MEDLINE, EMBASE, CINAHL) January 1, 2009 to September 5, 2013 to identify relevant studies. The inclusion criteria were human randomized controlled trials published in the English language in which active therapeutic ultrasound was compared tosham ultrasound, data for people with knee OA were reported separately, participants were blinded to treatment allocation and outcomes assessed before and after treatment included pain, self-reported physical function and performance-based physical function. Two reviewers independently screened titles and abstracts retrieved in the search to identify trials suitable for full text review. Data extraction and risk of bias assessment of the identified trials were completed independently by two reviewers. Pooled analyses were conducted using inverse-variance random effects models.RESULTS: We screened 1013 titles and abstracts. Meta-analysis of pain outcomes from 5 small trials(281 participants/OA knees) showed that, compared to sham ultrasound, therapeutic ultrasound improves pain [standardized mean difference(SMD)(95%CI) =-0.39(-0.70--0.08); P = 0.01] but not physical function [self-reported in 3 trials(130 participants/OA knees): SMD(95%CI) =-0.21(-0.55-0.14), P = 0.24; walking performance in 4 trials(130 participants/OA knees): SMD(95%CI) =-0.11(-0.59-0.37), P = 0.65). For the walking performance outcome, the dispersion of the estimated effects exceeded that expected due to sampling error(χ2 = 8.37, P = 0.04, I 2 = 64%). Subgroup analyses of three trials that administered high dose ultrasound improved the consistency(I2 = 28%) but the treatment effect remained insignificant.CONCLUSION: Meta-analyzed double-blind placebocontrolled randomized trials provide low-strength evidence tha展开更多
目的总结缺血性卒中患者预防肺栓塞的最新、最佳证据,为临床护理实践提供循证依据。方法计算机检索BMJ最佳实践(BMJ Best Practice)、UpToDate、英国国家卫生与临床优化指南库(National Institute for Health and Care Excellence,NICE)...目的总结缺血性卒中患者预防肺栓塞的最新、最佳证据,为临床护理实践提供循证依据。方法计算机检索BMJ最佳实践(BMJ Best Practice)、UpToDate、英国国家卫生与临床优化指南库(National Institute for Health and Care Excellence,NICE)、PubMed、Cochrane Library和中国知网等21个数据库和指南网站关于预防缺血性卒中患者肺栓塞的指南、临床决策、最佳实践、证据总结、系统评价、专家共识和随机对照试验,检索文献的发表时间为2010年1月-2021年7月。采用临床指南研究与评价系统Ⅱ(appraisal of guidelines for research and evaluationⅡ,AGREEⅡ)、系统评价评估系统(assessment of multiple systematic reviews 2,AMSTAR 2)和澳大利亚Joanna Briggs循证卫生保健中心(Joanna Briggs Institute,JBI)文献质量评价标准对相应文献进行评价,并采用JBI的证据分级系统对纳入证据进行证据分级和证据推荐。结果共纳入28篇文献,其中指南17篇、系统评价4篇、专家共识4篇、随机对照试验2篇、证据总结1篇。分别从入院评估、健康宣教、基本预防、机械预防、药物预防、病情监测6个维度总结了共计28条最佳证据。结论缺血性卒中患者预防肺栓塞的证据总结涵盖了自入院评估至出院宣教的全过程,证据生成过程科学,针对性强,可为临床护理实践提供一定参考。展开更多
文摘目的基于循证方法总结ICU气管插管患者拔管后吞咽障碍(PED)康复护理最佳证据。方法遵照“6S”证据检索模型,检索BMJ Best Practice、UpToDate、国际指南协作网(GIN)、英国国家卫生与临床优化研究所(NICE)网站、苏格兰学院间指南网(SIGN)、美国国立指南网(NGC)、医脉通网站、Cochrane Library、澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心网站、PubMed、Embase、卫生保健及护理学数据库(CINAHL)、中国知网、中国生物医学文献数据库、万方数据知识服务平台中有关ICU气管插管患者PED康复护理相关研究,检索时间为建库至2023年9月。由2名研究人员独立进行文献筛选及资料提取、文献质量评价。结果最终纳入文献12篇,包括专家共识5篇、系统评价4篇、指南2篇、临床决策1篇。最终形成了ICU气管插管患者PED康复护理最佳证据,其包括人员筹备、筛查与评估、基础训练、代偿训练、并发症管理、口腔护理、教育与培训7个类别共32条证据,各证据的等级为1a~5b级,推荐级别为A~B级。结论本研究基于循证方法总结了ICU气管插管患者PED康复护理最佳证据,包括人员筹备、筛查与评估、基础训练、代偿训练、并发症管理、口腔护理、教育与培训7个类别共32条证据。
基金Supported by The Canadian Institutes of Health Research Randomized Controlled Trials Mentorship Program(NJM,MB),No.MTP 108229
文摘AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis(OA). METHODS: We hand searched meta-analyses on the topic published in 2010 and updated the search in three electronic databases(MEDLINE, EMBASE, CINAHL) January 1, 2009 to September 5, 2013 to identify relevant studies. The inclusion criteria were human randomized controlled trials published in the English language in which active therapeutic ultrasound was compared tosham ultrasound, data for people with knee OA were reported separately, participants were blinded to treatment allocation and outcomes assessed before and after treatment included pain, self-reported physical function and performance-based physical function. Two reviewers independently screened titles and abstracts retrieved in the search to identify trials suitable for full text review. Data extraction and risk of bias assessment of the identified trials were completed independently by two reviewers. Pooled analyses were conducted using inverse-variance random effects models.RESULTS: We screened 1013 titles and abstracts. Meta-analysis of pain outcomes from 5 small trials(281 participants/OA knees) showed that, compared to sham ultrasound, therapeutic ultrasound improves pain [standardized mean difference(SMD)(95%CI) =-0.39(-0.70--0.08); P = 0.01] but not physical function [self-reported in 3 trials(130 participants/OA knees): SMD(95%CI) =-0.21(-0.55-0.14), P = 0.24; walking performance in 4 trials(130 participants/OA knees): SMD(95%CI) =-0.11(-0.59-0.37), P = 0.65). For the walking performance outcome, the dispersion of the estimated effects exceeded that expected due to sampling error(χ2 = 8.37, P = 0.04, I 2 = 64%). Subgroup analyses of three trials that administered high dose ultrasound improved the consistency(I2 = 28%) but the treatment effect remained insignificant.CONCLUSION: Meta-analyzed double-blind placebocontrolled randomized trials provide low-strength evidence tha
文摘目的总结缺血性卒中患者预防肺栓塞的最新、最佳证据,为临床护理实践提供循证依据。方法计算机检索BMJ最佳实践(BMJ Best Practice)、UpToDate、英国国家卫生与临床优化指南库(National Institute for Health and Care Excellence,NICE)、PubMed、Cochrane Library和中国知网等21个数据库和指南网站关于预防缺血性卒中患者肺栓塞的指南、临床决策、最佳实践、证据总结、系统评价、专家共识和随机对照试验,检索文献的发表时间为2010年1月-2021年7月。采用临床指南研究与评价系统Ⅱ(appraisal of guidelines for research and evaluationⅡ,AGREEⅡ)、系统评价评估系统(assessment of multiple systematic reviews 2,AMSTAR 2)和澳大利亚Joanna Briggs循证卫生保健中心(Joanna Briggs Institute,JBI)文献质量评价标准对相应文献进行评价,并采用JBI的证据分级系统对纳入证据进行证据分级和证据推荐。结果共纳入28篇文献,其中指南17篇、系统评价4篇、专家共识4篇、随机对照试验2篇、证据总结1篇。分别从入院评估、健康宣教、基本预防、机械预防、药物预防、病情监测6个维度总结了共计28条最佳证据。结论缺血性卒中患者预防肺栓塞的证据总结涵盖了自入院评估至出院宣教的全过程,证据生成过程科学,针对性强,可为临床护理实践提供一定参考。
