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Medication management information priorities of people living with dementia and their carers: a scoping review 痴呆症患者及其照护者在用药管理信息方面的优先考虑事项:范围界定综述
IF 6.7 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-17 DOI: 10.1093/ageing/afae200
Alexander J Clough, Danijela Gnjidic, Amanda J Cross, Natali Jokanovic, Karen Watson, Jacqueline Wesson, Stephanie Beshara, Justin Cheng, Mouna J Sawan
Background People living with dementia and their carers often experience difficulties in effectively managing medications and have indicated they lack necessary support, information and guidance. Recognising the medication management information needs of this population is an important first step in addressing these issues. Objectives To identify the priorities for information on medication management expressed by people living with dementia and their carers. Methods A scoping review with systematic search was conducted from inception to 12 May 2023 for any original studies that reported the information needs of people living with dementia and their carers (informal, i.e. unpaid or within an existing relationship) regarding medication management. Two authors independently screened the abstracts, full-texts and extracted data. Study characteristics were described descriptively, and themes of information need were extracted using an iterative approach. Results Of the 11 367 records screened, 35 full-texts were included. All studies (n = 35) involved carers, with 17 also including people living with dementia. Most studies (n = 30) were conducted in the community and used qualitative methods (n = 32). Five major themes of information need were identified: critical medication information; medication effects; medication indication(s); disease progression and impact on medications; and safe and appropriate administration of medications. People living with dementia and their carers indicated they need more medication management information generally and want it simple, tailored and relevant. Conclusions This review highlights the key medication information priorities for people living with dementia and their carers and will help guide the provision of medication management guidance and development of new information resources.
背景痴呆症患者及其照顾者在有效管理药物方面经常遇到困难,并表示他们缺乏必要的支持、信息和指导。认识到这一人群对药物管理信息的需求是解决这些问题的重要第一步。目标 确定痴呆症患者及其照护者对药物管理信息的需求重点。方法 对痴呆症患者及其照护者(非正式的,即无报酬的或现有关系中的)在药物管理方面的信息需求进行原始研究的范围界定和系统检索,检索时间从开始至 2023 年 5 月 12 日。两位作者独立筛选了摘要和全文,并提取了数据。对研究特点进行了描述,并采用迭代法提取了信息需求主题。结果 在筛选出的 11 367 条记录中,有 35 篇全文被收录。所有研究(n = 35)均涉及照护者,其中 17 项研究还包括痴呆症患者。大多数研究(n = 30)在社区进行,并采用了定性方法(n = 32)。研究确定了信息需求的五大主题:关键用药信息;用药效果;用药指征;疾病进展及对用药的影响;以及安全、适当的用药。痴呆症患者及其照护者表示,他们普遍需要更多的药物管理信息,并希望这些信息简单、有针对性且相关。结论 本综述强调了痴呆症患者及其照护者在用药信息方面的主要优先事项,将有助于指导用药管理指南的提供和新信息资源的开发。
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引用次数: 0
Quality of life, pain and use of analgesic, anxiolytic and antidepressant medication, in people living in care homes. 居住在护理院的人的生活质量、疼痛以及镇痛、抗焦虑和抗抑郁药物的使用情况。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae196
Jemima T Collins, Lisa Irvine, Pip Logan, Katie Robinson, Erika Sims, Adam L Gordon

Background: People living in care homes often have problems with pain, anxiety and depression. Whether being on analgesia, anxiolytics or antidepressants has any bearing on pain severity and quality of life (QoL) in this population, requires further investigation.

Objectives: (i) to examine the relationship between pain, anxiety and depression and medication use in care home residents and (ii) to compare those on medications to treat pain, anxiety and depression, and those who were not, and associations with pain severity and overall QoL.

Methods: This was a secondary analysis of a randomised controlled trial testing a falls prevention intervention in care homes. We recorded pain, anxiety and depression, QoL measurements and prescribed medication use.

Results: In 1589 participants, the mean age was 84.7 years (±9.3 SD), 32.2% were male and 67.3% had a diagnosis of dementia. 54.3% and 53.2% of participants had some level of pain and anxiety or depression respectively, regardless of prescribed medication use. There was a direct association between pain severity and being on any analgesia, opioid analgesia, and antidepressants, but no associations between pain severity and use of paracetamol and anxiolytics. QoL was best for residents with no pain and not on any analgesia, anxiolytics or antidepressants and worst for those with moderate-extreme pain and taking at least two of these classes of medications.

Conclusion: Many care home residents live with pain, anxiety and depression. Addressing residents' pain may also increase their quality of life, but using medication alone to reach this goal may be inadequate.

背景介绍住在护理院的人通常有疼痛、焦虑和抑郁问题。目标:(i) 研究疗养院居民的疼痛、焦虑和抑郁与用药之间的关系;(ii) 比较那些服用药物治疗疼痛、焦虑和抑郁的人和那些没有服用药物的人,以及他们与疼痛严重程度和总体 QoL 之间的关系:这是对一项随机对照试验的二次分析,该试验测试了在护理院中预防跌倒的干预措施。我们记录了疼痛、焦虑和抑郁、QoL 测量值和处方药使用情况:在 1589 名参与者中,平均年龄为 84.7 岁(±9.3 SD),32.2% 为男性,67.3% 被诊断患有痴呆症。54.3%和53.2%的参与者分别有一定程度的疼痛、焦虑或抑郁,与处方药的使用无关。疼痛严重程度与使用任何镇痛药、阿片类镇痛药和抗抑郁药有直接关系,但疼痛严重程度与使用扑热息痛和抗焦虑药没有关系。无痛且未服用任何镇痛药、抗焦虑药或抗抑郁药的住户的生活质量最好,而中度至极度疼痛且至少服用两种此类药物的住户的生活质量最差:结论:许多护理院住户都伴有疼痛、焦虑和抑郁。解决住客的疼痛问题也可以提高他们的生活质量,但仅靠药物治疗可能不足以达到这一目标。
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引用次数: 0
Trend and driving factors in burden of age-related macular degeneration in older adults aged 60-89 years: a global analysis over three decades. 60-89 岁老年人老年性黄斑变性负担的趋势和驱动因素:三十年来的全球分析。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae207
Qin-Yu Ni, Meng-Yao Wu, Chen-Kai Zha, Yu Wen, Lan Zhong, Jing-Jing Ding, Xue-Yan Li, Li-Ming Tao, Zheng-Xuan Jiang, Fan Cao

Background: To explore temporal trends and determine driving factors of age-related macular degeneration (AMD) burden in older adults aged 60-89 years at global, regional and national levels from 1990 to 2019.

Methods: Prevalence and years lived with disability (YLDs) were extracted. Joinpoint regression analysis was adopted to calculate average annual percentage change and to identify the year with the most significant changes. Global trends were stratified by sex, age and sociodemographic index, and regional and national trends were explored. Decomposition analysis was conducted to determine what extent the forces of population size, age structure and epidemiologic change driving alterations of AMD burden.

Results: Globally, prevalence rate slightly increased whereas YLDs rate decreased. The year 2005 marked a turning point where both prevalence and YLDs started to decline. Regionally, Western Sub-Saharan Africa had the highest prevalence and YLDs rates in 2019, with East Asia experiencing the most notable rise in prevalence from 1990 to 2019. Global decomposition revealed that the increased case number was primarily driven by population growth and ageing, and epidemiological change was only detected to lessen but far from offset these impacts.

Conclusions: Although there was only slight increase or even decrease in prevalence and YLDs rates of AMD in older adults, the case number still nearly doubled, which may be primarily attributed to population growth and ageing, coupled with the emerging growing pattern of prevalence rate from 2015, collectively suggesting a huge challenge in control and management of AMD.

背景:探讨 1990 年至 2019 年全球和地区及国家层面 60-89 岁老年人老年性黄斑变性(AMD)负担的时间趋势并确定驱动因素:探讨 1990 年至 2019 年全球、地区和国家层面 60-89 岁老年人年龄相关性黄斑变性(AMD)负担的时间趋势并确定驱动因素:方法:提取患病率和残疾生活年数(YLDs)。采用连接点回归分析法计算年均百分比变化,并确定变化最显著的年份。按性别、年龄和社会人口指数对全球趋势进行了分层,并探讨了地区和国家趋势。进行了分解分析,以确定人口数量、年龄结构和流行病学变化在多大程度上推动了 AMD 负担的变化:结果:在全球范围内,患病率略有上升,而青年白内障患病率则有所下降。2005 年是一个转折点,患病率和 YLDs 都开始下降。从地区来看,2019年撒哈拉以南非洲西部的患病率和YLDs率最高,东亚地区的患病率从1990年到2019年上升最为明显。全球分解显示,病例数增加的主要原因是人口增长和老龄化,而流行病学的变化只能减轻但远远不能抵消这些影响:结论:虽然老年人AMD的患病率和YLDs率仅略有上升甚至下降,但病例数仍增加了近一倍,这可能主要归因于人口增长和老龄化,再加上从2015年开始出现的患病率增长模式,共同表明AMD的控制和管理面临巨大挑战。
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引用次数: 0
Editor's view-ageing in place. 编辑观点--就地养老。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae206
Roy L Soiza
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引用次数: 0
Visual field loss and falls requiring hospitalisation: results from the eFOVID study. 视野缺损与需要住院治疗的跌倒:eFOVID 研究结果。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae191
Siobhan Manners, Lynn B Meuleners, Jonathon Q Ng, Joanne M Wood, Bill Morgan, Nigel Morlet

Background: Visual fields are important for postural stability and ability to manoeuvre around objects.

Objective: Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +.

Methods: Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists' practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: -2 to -6 dB, moderate: -6.01 dB to -12 dB, severe < -12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders.

Results: A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <-12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0-1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39-39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38-1.60) and diabetes (IRR 1.25, 95% CI 1.14-1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81-0.95) compared with those who did not have cataract surgery.

Conclusion: The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.

背景视野对姿势稳定性和在物体周围活动的能力非常重要:研究 50 岁以上成年人视野缺损与需要住院治疗的跌倒之间的关系:方法:利用从西澳大利亚州(WA)眼科医生的跨部门实践中获得的视野数据库,对患有和不患有视野缺损的 50 岁以上老年人进行识别。数据与医院发病率数据收集系统和西澳大利亚州医院死亡率系统相连接,以确定1990年至2019年期间因跌倒而住院的参与者。在对潜在混杂因素进行调整后,一个广义线性负二项回归模型根据最近一次视野测试(跌倒前3年或跌倒后2年,如果无法获得)中的较好眼平均偏差(轻度:-2至-6 dB,中度:-6.01 dB至-12 dB,重度<-12.01 dB),检验了有视野缺失和无视野缺失者跌倒住院之间的关联:在中位 14.1 年的观察时间内,共有 31 021 人发生了 11 818 次跌倒,其中 6054 人(19.5%)需要住院治疗。结论:研究结果突出了持续临床观察的重要性:研究结果凸显了对视野缺损的老年人进行持续的视野缺损临床监测和伤害预防策略的重要性。
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引用次数: 0
Correction to: Revisiting unstable disability and the fluctuations of frailty: a measurement burst approach. 更正:重新审视不稳定残疾和虚弱的波动:一种测量突变方法。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae203
{"title":"Correction to: Revisiting unstable disability and the fluctuations of frailty: a measurement burst approach.","authors":"","doi":"10.1093/ageing/afae203","DOIUrl":"10.1093/ageing/afae203","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and validation of a prognostic scoring system for 1-year mortality in older patients with hip fractures. 针对老年髋部骨折患者 1 年死亡率的预后评分系统的开发与验证。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae195
Yusei Katsuyama, Naoyuki Horie, Kengo Yoshii, Shinichiro Nakamura, Tomoki Saito, Kenji Takahashi

Background: Hip fractures in older people result in increased mortality.

Objective: We developed and validated an accurate and simple prognostic scoring system for hip fractures that can be used preoperatively.

Design: Retrospective study.

Setting: Multicenter.

Participants: Patients aged ≥65 years with hip fractures who underwent surgery between 2011 and 2021 were enrolled.

Methods: The significant factors were determined with logistic regression analysis, and a scoring system was developed. The patients were classified into three groups, and a log-rank test was performed to evaluate 1-year survival rates. The model was internally and externally validated using the 5-fold cross-validation and data from another hospital, respectively.

Results: We included 1026 patients. The analysis revealed eight significant prognostic factors: sex, body mass index, history of chronic heart failure and malignancy, activities of daily living (ADLs) before injury, hemoglobin and the prognostic nutritional index (PNI) at injury, and the American Society of Anesthesiologists Physical Status. The area under the receiver operating characteristic curve (AUC) after internal validation was 0.853. The external validation data consisted of 110 patients. The AUC of the model for the validation data was 0.905, showing outstanding discrimination. Sensitivity and specificity were 88.7% vs. 100% and 93.3% vs. 95.2% for the development and validation data, respectively.

Conclusions: We developed and validated an accurate and simple prognostic scoring system for hip fractures using only preoperative factors. Our findings highlight PNI as an important predictor of prognosis in hip fracture patients.

背景:老年人髋部骨折会增加死亡率:老年人髋部骨折导致死亡率增加:我们开发并验证了一套准确而简单的髋部骨折预后评分系统,可在术前使用:设计:回顾性研究:多中心研究:年龄≥65岁、在2011年至2021年期间接受手术治疗的髋部骨折患者:方法:通过逻辑回归分析确定重要因素,并建立评分系统。将患者分为三组,并进行对数秩检验以评估1年生存率。分别使用 5 倍交叉验证和另一家医院的数据对模型进行了内部和外部验证:我们共纳入了 1026 名患者。分析发现了八个重要的预后因素:性别、体重指数、慢性心力衰竭和恶性肿瘤病史、受伤前的日常生活活动能力(ADLs)、受伤时的血红蛋白和预后营养指数(PNI)以及美国麻醉医师协会体能状况。内部验证后的接收器操作特征曲线下面积(AUC)为 0.853。外部验证数据包括 110 名患者。验证数据模型的 AUC 为 0.905,显示了出色的辨别能力。开发数据和验证数据的灵敏度和特异度分别为 88.7% 对 100% 和 93.3% 对 95.2%:我们开发并验证了一种仅使用术前因素的准确而简单的髋部骨折预后评分系统。我们的研究结果表明,PNI 是预测髋部骨折患者预后的重要指标。
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引用次数: 0
New horizons in prediction modelling using machine learning in older people's healthcare research. 在老年人医疗保健研究中使用机器学习进行预测建模的新视野。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae201
Daniel Stahl

Machine learning (ML) and prediction modelling have become increasingly influential in healthcare, providing critical insights and supporting clinical decisions, particularly in the age of big data. This paper serves as an introductory guide for health researchers and readers interested in prediction modelling and explores how these technologies support clinical decisions, particularly with big data, and covers all aspects of the development, assessment and reporting of a model using ML. The paper starts with the importance of prediction modelling for precision medicine. It outlines different types of prediction and machine learning approaches, including supervised, unsupervised and semi-supervised learning, and provides an overview of popular algorithms for various outcomes and settings. It also introduces key theoretical ML concepts. The importance of data quality, preprocessing and unbiased model performance evaluation is highlighted. Concepts of apparent, internal and external validation will be introduced along with metrics for discrimination and calibration for different types of outcomes. Additionally, the paper addresses model interpretation, fairness and implementation in clinical practice. Finally, the paper provides recommendations for reporting and identifies common pitfalls in prediction modelling and machine learning. The aim of the paper is to help readers understand and critically evaluate research papers that present ML models and to serve as a first guide for developing, assessing and implementing their own.

机器学习(ML)和预测建模在医疗保健领域的影响力与日俱增,尤其是在大数据时代,可提供重要的见解并支持临床决策。本文为对预测建模感兴趣的健康研究人员和读者提供了入门指南,探讨了这些技术如何支持临床决策,尤其是大数据,并涵盖了使用 ML 开发、评估和报告模型的各个方面。本文首先介绍了预测建模对精准医疗的重要性。它概述了不同类型的预测和机器学习方法,包括监督学习、无监督学习和半监督学习,并概述了针对不同结果和设置的流行算法。它还介绍了关键的机器学习理论概念。强调了数据质量、预处理和无偏见模型性能评估的重要性。本文将介绍表观验证、内部验证和外部验证的概念,以及针对不同类型结果的判别和校准指标。此外,本文还讨论了临床实践中的模型解释、公平性和实施问题。最后,本文将提供报告建议,并指出预测建模和机器学习中的常见误区。本文旨在帮助读者理解和批判性地评估介绍机器学习模型的研究论文,并为开发、评估和实施自己的模型提供初步指导。
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引用次数: 0
Alcohol consumption and frailty risk: a dose-response meta-analysis of cohort studies. 饮酒与虚弱风险:队列研究的剂量反应荟萃分析。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae199
Sepideh Soltani, Ahmad Jayedi, Seyedmojtaba Ghoreishy, Mahdieh Mousavirad, Samira Movahed, Maedeh Jabbari, Farzaneh Asoudeh

Background/aims: While previous studies suggest that light-to-moderate alcohol consumption may reduce the frailty risk, the dose-response relationship is still under question. To address the knowledge gap, we conducted a systematic review and dose-response meta-analysis of cohort studies to examine the association of alcohol consumption with the risk of both prefrailty and frailty in adults.

Methods: We searched MEDLINE (Ovid), PubMed and Scopus to identify relevant cohort studies published before 8 May 2024. The dose-response meta-analysis was performed to investigate the associations between alcohol drinking and the risk of developing pre-frailty and frailty. We used random-effects models to calculate pooled relative risks (RR) with 95% CIs.

Results: We included nine cohort studies with 64 769 participants and 15 075 cases, of which eight studies were rated to have a serious risk of bias as assessed by the ROBINS tool. Based on our analysis, each 12 g increase in alcohol intake did not appear to be associated with risks of prefrailty (RR: 1.08, 95% CI 0.89, 1.31; I2 = 91%, n = 3; GRADE = very low) and frailty (RR: 0.94, 95% CI 0.88, 1.00; I2 = 63%, n = 9; GRADE = low). The nonlinear dose-response meta-analysis indicates a slight inverse association with frailty risk up to an alcohol intake of 20 grams per day, beyond which an upward trend is observed.

Conclusion: The inverse association found between moderate alcohol consumption and frailty risk appears to be stronger among older adults, which might be due to the lower and less popular alcohol consumption among older people than the general population. However, because this finding is based on low-quality evidence, more research is needed to develop specific dietary recommendations for alcohol consumption, particularly among young people.

背景/目的:尽管以往的研究表明,轻度至中度饮酒可降低虚弱风险,但其剂量-反应关系仍存在疑问。为了填补这一知识空白,我们对队列研究进行了系统回顾和剂量-反应荟萃分析,以研究饮酒与成人虚弱前期和虚弱风险之间的关系:我们检索了 MEDLINE (Ovid)、PubMed 和 Scopus,以确定 2024 年 5 月 8 日之前发表的相关队列研究。我们进行了剂量-反应荟萃分析,以研究饮酒与罹患虚弱前期和虚弱风险之间的关联。我们使用随机效应模型来计算汇集的相对风险系数(RR)和 95% CIs:我们纳入了九项队列研究,共有 64 769 名参与者和 15 075 个病例,其中八项研究经 ROBINS 工具评估被评为存在严重偏倚风险。根据我们的分析,酒精摄入量每增加 12 克似乎与虚弱前期(RR:1.08,95% CI 0.89,1.31;I2 = 91%,n = 3;GRADE = 很低)和虚弱期(RR:0.94,95% CI 0.88,1.00;I2 = 63%,n = 9;GRADE = 低)的风险无关。非线性剂量-反应荟萃分析表明,每天酒精摄入量不超过 20 克时,虚弱风险与酒精摄入量呈轻微的负相关,超过 20 克后,则呈上升趋势:结论:适量饮酒与虚弱风险之间的反向关系在老年人中似乎更为明显,这可能是由于老年人的饮酒量低于普通人群,且不太普遍。然而,由于这一发现是基于低质量的证据,因此需要进行更多的研究,以制定有关饮酒,尤其是年轻人饮酒的具体饮食建议。
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引用次数: 0
Hip fracture has profound psychosocial impacts: a systematic review of qualitative studies. 髋部骨折具有深远的社会心理影响:定性研究的系统回顾。
IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-01 DOI: 10.1093/ageing/afae194
Nicholas F Taylor, Made U Rimayanti, Casey L Peiris, David A Snowdon, Katherine E Harding, Adam I Semciw, Paul D O'Halloran, Elizabeth Wintle, Scott Williams, Nora Shields

Background: Hip fracture is a common and serious traumatic injury for older adults characterised by poor outcomes.

Objective: This systematic review aimed to synthesise qualitative evidence about the psychosocial impact of hip fracture on the people who sustain these injuries.

Methods: Five databases were searched for qualitative studies reporting on the psychosocial impact of hip fracture, supplemented by reference list checking and citation tracking. Data were synthesised inductively and confidence in findings reported using the Confidence in the Evidence from Reviews of Qualitative research approach, taking account of methodological quality, coherence, relevance and adequacy.

Results: Fifty-seven studies were included. Data were collected during the peri-operative period to >12 months post fracture from 919 participants with hip fracture (median age > 70 years in all but 3 studies), 130 carers and 297 clinicians. Hip fracture is a life altering event characterised by a sense of loss, prolonged negative emotions and fear of the future, exacerbated by negative attitudes of family, friends and clinicians. For some people after hip fracture there is, with time, acceptance of a new reality of not being able to do all the things they used to do. There was moderate to high confidence in these findings.

Conclusions: Hip fracture is a life altering event. Many people experience profound and prolonged psychosocial distress following a hip fracture, within a context of negative societal attitudes. Assessment and management of psychosocial distress during rehabilitation may improve outcomes for people after hip fracture.

背景:髋部骨折是老年人常见的严重创伤:髋部骨折是老年人常见的严重外伤,其特点是治疗效果不佳:本系统综述旨在综合有关髋部骨折对受伤者心理社会影响的定性证据:方法:在五个数据库中搜索了有关髋部骨折对社会心理影响的定性研究报告,并辅以参考文献列表检查和引文追踪。在考虑方法质量、一致性、相关性和充分性的基础上,采用 "定性研究综述证据置信度 "方法对数据进行归纳综合,并报告研究结果的置信度:结果:共纳入 57 项研究。收集了 919 名髋部骨折患者(除 3 项研究外,其他研究的中位年龄均大于 70 岁)、130 名照护者和 297 名临床医生从手术围手术期到骨折后 12 个月内的数据。髋部骨折是一个改变生活的事件,其特点是失落感、长期的负面情绪和对未来的恐惧,而家人、朋友和临床医生的负面态度又加剧了这种失落感、负面情绪和对未来的恐惧。对于一些髋部骨折患者来说,随着时间的推移,他们会接受新的现实,即不能再做以前能做的所有事情。这些研究结果的可信度从中等到高等不等:髋部骨折是一个改变生活的事件。结论:髋部骨折是一个改变生活的事件,许多人在髋部骨折后都会在消极的社会态度下经历深刻而漫长的心理社会痛苦。在康复过程中对社会心理压力进行评估和管理可改善髋部骨折患者的康复效果。
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引用次数: 0
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