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护理学报 ›› 2021, Vol. 28 ›› Issue (18): 22-27.doi: 10.16460/j.issn1008-9969.2021.18.022

• 循证护理 • 上一篇    下一篇

老年肿瘤患者跌倒评估及管理最佳证据总结

蔡莹莹1a, 张俊峰2, 郑可欣3, 张兰芳4, 余璐萍5, 曾文2, 陈梦云1b, 黄琼珊1b   

  1. 1.揭阳市人民医院 a.肿瘤内科三科;b.护理部,广东 揭阳 522000;
    2.东莞市松山湖中心医院 护理部,广东 东莞 523325;
    3.珠海市慢性病防治中心 精神科二区,广东 珠海 515000;
    4.南方医科大学南方医院 放疗科,广东 广州 510400;
    5.中山市人民医院 护理部,广东 中山 528400
  • 收稿日期:2021-05-15 出版日期:2021-09-25 发布日期:2021-10-12
  • 作者简介:蔡莹莹（1992-）,女,广东揭阳人,硕士,主管护师。
  • 基金资助:
    广东省科学技术厅立项项目（2017ZC0473）

Best Evidence Summary for Assessment and Management of Falls in Elderly Cancer Patients

CAI Ying-ying1a, ZHANG Jun-feng2, ZHENG Ke-xin3, ZHANG Lan-fang4, YU Lu-ping5, ZENG Wen2, CHEN Meng-yun1b, HUANG Qiong-shan1b   

  1. 1a. The 3rd Unit of Oncology Department; 1b. Dept. of Nursing Administration, Jieyang People's Hospital, Jieyang 522000, China;
    2. Dept. of Nursing Administration, Songshanhu Central Hospital, Dongguan 523325, China;
    3. The 2nd Unit of Psychiatric Department, Center of Chronic Disease Control, Zhuhai 515000, China;
    4. Dept. of Radiotherapy, Nanfang Hospital, Southern Medical University, Guangzhou 510400, China;
    5. Dept. of Nursing Administration, Zhongshan Peoples'Hospital, Zhongshan 528400, China
  • Received:2021-05-15 Online:2021-09-25 Published:2021-10-12

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摘要： 目的 总结老年肿瘤患者跌倒评估及管理的最佳证据,为我国临床实践提供参考依据。方法 使用PICO模型确定循证问题,计算机检索有关老年肿瘤患者跌倒评估及管理的证据资源,包括指南、证据总结、最佳实践信息册、专家共识、系统评价、文献综述、随机对照研究。由2名完成循证护理培训课程的研究者分别进行文献筛选、文献质量评价、证据级别划分、证据提取及汇总。结果 最终纳入7篇文献,包括指南3篇,系统评价1篇,文献综述2篇,随机对照研究1篇,从跌倒风险初步筛查、跌倒风险综合评估、干预措施3个维度总结了26条最佳证据。结论 评估是预防老年肿瘤患者跌倒的前提,采取综合的干预措施能有效预防老年肿瘤患者跌倒的发生。最佳证据的应用,需结合医护人员的专业判断,综合考虑患者的需求和偏好、应用证据的场景,分析障碍和促进因素,以制订符合我国临床实践的老年肿瘤患者跌倒评估及管理策略。

关键词: 肿瘤患者, 跌倒, 评估, 管理, 最佳证据, 循证护理

Abstract: Objective To summarize the best evidence for the assessment and management of falls in elderly cancer patients, and to provide reference for clinical practice in China. Methods With PICO model, the evidence-based questions were identified; computer-based retrieval of evidence resources for falls assessment and management including guidelines, summary of evidence, best practice information book, expert consensus, systematic review, literature review, and randomized controlled trials in elderly cancer patients was performed. Literature screening, literature quality evaluation, classification of evidence grade and recommendation grade, evidence extraction and summary were conducted by 2 researchers who completed the evidence-based nursing training. Results Seven articles were included, including 3 guidelines, 1 systematic review, 2 literature reviews, and 1 randomized controlled trial and 26 pieces of best evidence were summarized from 3 dimensions of initial screening, comprehensive evaluation and intervention measures. Conclusion Assessment is the premise to prevent the falls of elderly cancer patients and comprehensive intervention is effective for the prevention of the falls of elderly cancer patients. The application of the best evidence should be based on the professional judgment of the medical staff, the needs and preferences of the patients, the application context of the evidence, and the analysis of barriers and facilitating factors, so as to formulate the evaluation and management strategy of falls for elderly cancer patients in accordance with clinical practice in China.

Key words: cancer patient, fall, assessment, management, best evidence, evidence-based nursing

中图分类号: 

  • R47
[1] World Health Organization. Falls[EB/OL]. (2021-04-26)[2021-06-11].https://www.who.int/en/news-room/fact-sheets/detail/falls.
[2] Dotan E, Walter LC, Baumgartner J, et al. NCCN Guidelines Version 1.2020: Older Adult Oncology [EB/OL]. (2020-02-07) [2020-10-24]. https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf.
[3] Sattar S, Haase K, Kuster S, et al.Falls in Older Adults with Cancer: an Updated Systematic Review of Prevalence, Injurious Falls,and Impact on Cancer Treatment[J].Support Care Cancer,2021,29(1):21-33.DOI:10.1007/s00520-020-05619-2.
[4] 叶晶,苏莉,周萌,等.养老机构老年人跌倒预防措施的证据总结[J].护理研究,2019,33(24):4240-4246. DOI: 10.12102/j.issn.1009-6493.2019.24.010.
[5] Guerard EJ, Deal AM, Williams GR, et al.Falls in Older Adults with Cancer: Evaluation by Oncology Providers[J]. J Oncol Pract, 2015,11(6):470-474. DOI: 10.1200/JOP.2014.003517.
[6] Sandra L, Deborah D.Johns Hopkins Nursing Evidence-based Practice Model and Guidelines[M]. Indiana:Sigma Theta Tau International,2007:24.
[7] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: Advancing Guideline Development,Reporting and Evaluation in Health Care[J]. Review, 2010, 182(18):839-842. DOI:10.1503/cmaj.090449.
[8] 姚小云,陈红宇,胡君娥,等.癌症患者化疗相关性便秘评估与管理最佳证据总结[J].护理学报,2020,27(2):48-52. DOI: 10.16460/j.issn1008-9969.2020.02.048.
[9] The Joanna Briggs Institute.Critical Appraisal Tools [EB/OL]. (2017-11-24) [2020-10-10]. https://joannabriggs.org/critical-appraisal-tools.
[10] 王青春,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.DOI:10.16821/j.cnki.hsjx.2015.11.002.
[11] Cohen HJ, Wong ML, Drews RE, et al. Comprehensive Geriatric Assessment for Patients with Cancer[ER/OL]. (2020-02-19)[2021-10-24].https://www.uptodate.com/contents/comprehensive-geriatric-assessment-for-patients-with-cancer?search=Comprehensive%20geriatric%20assessment%20for%20patients%20with%20cancer&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.
[12] Mohile SG, Dale W, Somerfield MR, et al.Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology[J]. J Clin Oncol, 2018, 36(22):2326-2347. DOI: 10.1200/JCO.2018.78.8687.
[13] Williams AD, Bird ML, Hardcastle SG, et al. Exercise for Reducing Falls in People Living with and beyond Cancer[J].Cochrane Database Syst Rev,2018, 10(10):CD011687.DOI: 10.1002/14651858.
[14] Sattar S, Kenis C, Haase K, et al.Falls in Older Patients with Cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology Review Paper[J]. J Geriatr Oncol, 2020, 11(1):1-7. DOI:10.1016/j.jgo.2019.03.020.
[15] Campbell G, Wolfe RA, Klem ML.Risk Factors for Falls in Adult Cancer Survivors: An Integrative Review[J]. Rehabil Nurs,2018,43(4):201-213.DOI:10.1097/rnj.0000000000000173.
[16] Schwenk M, Grewal GS, Holloway D, et al.Interactive Sensor-based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial[J]. Gerontology, 2016, 62(5): 553-563. DOI:10.1159/000442253.
[17] Winters-Stone K.Tai Ji Quan for the Aging Cancer Survivor: Mitigating the Accelerated Development of Disability, Falls, and Cardiovascular Disease from Cancer Treatment[J]. J Sport Health Sci, 2014, 3(1):52-57. DOI:10.1016/j.jshs.2013.11.003.
[18] Magnuson A, Sattar S, Nightingale G, et al.A Practical Guide to Geriatric Syndromes in Older Adults with Cancer: A Focus on Falls, Cognition, Polypharmacy, and Depression[J]. Am Soc Clin Oncol Educ Book, 2019,39:96-109. DOI: 10.1200/EDBK_237641.
[19] Pergolotti M, Williams GR, Campbell C, et al.Occupational Therapy for Adults with Cancer: Why It Matters[J]. Oncologist,2016,21(3):314-319.DOI:10.1634/theoncologist.2015-0335.
[20] 戴菁菁,朱宏伟.老年肿瘤患者化疗期间预防跌倒护理的研究进展[J].中华现代护理杂志, 2013,19(21):2600-2602. DOI:10.3760/cma.j.issn.1674-2907.2013.21.045.
[21] Tofthagen C, Visovsky C, Berry DL.Strength and Balance Training for Adults with Peripheral Neuropathy and High Risk of Fall: Current Evidence and Implications for Future Research[J]. Oncol Nurs Forum, 2012, 39(5):416-424. DOI:10.1188/12.ONF.E416-E424.
[22] 刘丽香,何文静,莫蓓蓉,等.老年住院患者跌倒风险评估工具的系统评价[J].中国护理管理,2019,19(8):1146-1153. DOI:10.3969/j.issn.1672-1756.2019.08.007.
[23] 赵怀晴,王素云.三种跌倒风险评估量表在神经内科住院患者中的应用研究[J].护士进修杂志,2018,33(19):1735-1737. DOI:10.16821/j.cnki.hsjx.2018.19.003.
[24] Caraceni A, Shkodra M.Cancer Pain Assessment and Classification[J]. Cancers (Basel), 2019, 11(4):510. DOI:10.3390/cancers11040510.
[25] Feller L, Khammissa RAG, Bouckaert M, et al.Pain: Persistent Postsurgery and Bone Cancer-related Pain[J]. [J] Int Med Res.2019, 47(2):528-543.DOI:10.1177/0300060518818296.
[26] European Partnership Action Against Cancer Consensus Group. Policy Statement on Multidisciplinary Cancer Care[J]. Eur J Cancer, 2014, 50(3):475-480. DOI:10.1016/j.ejca.2013.11.012.
[27] 郭晓贝,王颖,杨雪柯,等.基于患者参与框架的住院老年患者跌倒预防干预策略的实施[J]. 护理学杂志,2021,36(1):50-53. DOI:10.3870/j.issn.1001-4152.2021.01.050.
[28] 蔡张滢,傅声帆,陈炼炼,等.预防跌倒策略对老年患者陪护人员知信行水平的影响[J].护理与康复,2020,19(11):84-86. DOI:10.3969/j.issn.1671-9875.2020.11.023.
[29] 王艳,朱桂玲.肠造口术后患者基于行为改变理论的护理干预效果观察[J].护理学报, 2020, 27(8):54-58. DOI:10.16460/j.issn1008-9969.2020.08.054.
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