Parastomal Hernia Prevention, Assessment, and Management: A Scoping Review and Consensus-Based Best Practice Recommendations.

IF 1.8
Madeline Lemke, Kimberley LeBlanc, Mary Hill, Kevin Woo, Terry Zwiep
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引用次数: 0

Abstract

Purpose: This purpose of this project was to generate best practice recommendations for health care providers caring to individuals at risk of or experiencing a parastomal hernia.

Methods: This project was completed in 2 phases. A scoping literature review was conducted, and results were used to generate best practice statements guiding clinicians caring for persons undergoing or living with an abdominal ostomy. A modified Delphi method was used to generate consensus-based recommendations for care. Finally, these statements underwent external review.

Search strategy: A scoping review was conducted that focused on the definitions, etiology, epidemiology, pathophysiology, assessment, prevention, and management of parastomal hernias. Databases and resources searched were CINAHL; EMBASE; Google Scholar; MEDLINE via OVID, Nurses Specialized in Wound, Ostomy and Continence Canada; Nursing and Allied Health Source on ProQuest; Ordre des infirmiers et infirmières du Québec; PsycInfo; PubMed Registered Nurses' Association of Ontario (RNAO); and the Wound, Ostomy, Continence Nurses Society library.

Results: Our search retrieved 187 records; 65 were read in full and included in the scoping literature review used to generate proposed consensus statements. Consensus was reached on 15 statements that achieved a 96% or higher agreement among expert panelists. Twenty-eight professionals participated in expert review, and 96% (n = 27) reported they would recommend these best practice recommendations to support parastomal hernia practices.

Conclusion: This process generated 15 best practice recommendations that provide guidance to health care providers who care for patients with an ostomy to assess risk, prevent, assess, and manage parastomal hernias.

Implications: These recommendations were generated from a structured literature review of current best evidence, supported by consensus among a panel of clinical experts, and supported by external review. While they represent best practice in the prevention and management of parastomal hernias, further research is required to establish evidence-based preventive and treatment recommendations.

造口旁疝的预防、评估和管理:范围审查和基于共识的最佳实践建议。
目的:该项目的目的是为照顾有造口旁疝风险或经历过造口旁疝的个人的卫生保健提供者提供最佳实践建议。方法:本课题分两期完成。进行了一项范围文献综述,结果用于生成最佳实践声明,指导临床医生照顾接受或生活在腹部造口术中的患者。采用改进的德尔菲法产生基于共识的护理建议。最后,这些声明经过外部审查。检索策略:对造口旁疝的定义、病因学、流行病学、病理生理学、评估、预防和治疗进行了范围综述。检索的数据库和资源为CINAHL;EMBASE;谷歌学者;MEDLINE通过OVID,护士专业在伤口,造口和自制加拿大;基于ProQuest的护理与联合健康资源护工和护工的命令;PsycInfo;安大略省公共医学注册护士协会(RNAO);以及伤口,造口,失禁护士协会图书馆。结果:检索到187条记录;其中65项已全文阅读,并列入用于产生拟议的协商一致声明的范围界定文献审查。专家小组成员就15项声明达成了共识,达成了96%或更高的共识。28名专业人员参与了专家评审,96% (n = 27)报告他们会推荐这些最佳实践建议来支持造口旁疝的治疗。结论:该过程产生了15条最佳实践建议,为护理造口术患者的卫生保健提供者提供指导,以评估风险、预防、评估和管理造口旁疝。含义:这些建议来自对当前最佳证据的结构化文献综述,得到临床专家小组共识的支持,并得到外部评价的支持。虽然它们代表了预防和治疗造口旁疝的最佳实践,但需要进一步的研究来建立基于证据的预防和治疗建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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