Xiaoqiong Peng , Ping Xiao , Yuanyuan Liu , Tianwen Huang , Xiaomin Huang , Wanlian Xiao , Sijia Deng
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引用次数: 0
Abstract
Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors.
Objective
To gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms.
Methods
Based on the “6 S” pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence.
Results
Thirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted.
Conclusion
The study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients.
骨质疏松性骨折是骨质疏松症的严重并发症,通常采用手术治疗,其恢复与个人的行为和生活方式密切相关,是一个长期、复杂的管理过程,往往需要个体对许多与健康相关的因素进行自我管理。收集和综合有关骨质疏松性骨折术后患者自我管理的最有力证据,为临床医护人员提供科学、循证的指导,协助术后患者进行自我管理,并帮助患者优化自我管理实践和行为规范。基于证据资源的“6s”金字塔模型(系统、摘要、综合大纲、综合、研究大纲、研究),我们检索了Up To Date、BMJ最佳实践、Cochrane图书馆、澳大利亚乔安娜布里格斯研究所JBI循证医学中心卫生保健数据库、国家卫生与临床卓越研究所(NICE)、指南国际网络(GIN)、国家指南交换所(NGC)和苏格兰校际指南网络(SIGN)。检索MedPulse、Embase、PubMed、CINAHL、Web of Science、SinoMed、中华医学期刊全文数据库、CNKI、万方数据知识服务平台、VIP数据库等,检索期为骨质疏松性骨折术后患者自我管理的临床决策、系统评价、临床指南、证据总结和专家共识,检索期为数据库建立至2023年2月18日。为保证文献质量,由3名研究者按照文献纳入和排除标准对文献进行严格筛选,2名或2名以上研究者独立评价纳入文献的质量,并对相关证据进行提取和整合。最终纳入文献13篇,其中临床实践指南4篇,专家共识5篇,推荐做法2篇,系统评价1篇,临床决策报告1篇。研究团队从多学科团队合作、日常生活管理、治疗依从性管理、运动管理、预防跌倒及后续骨折管理、情绪管理6个维度对证据进行总结,提取证据33条。本研究总结了33例骨质疏松性骨折术后患者自我管理的最佳证据,为术后患者提供科学合理的自我管理方案,也为临床医护人员对患者进行更全面、科学的自我管理健康教育提供重要参考和信息。