护理干预对预防社区和医疗机构中老年人跌倒的有效性:对研究性试验的系统回顾和荟萃分析。

María Isabel Orts-Cortés , María José Cabañero-Martínez , Cristóbal Meseguer-Liza , Claudia P. Arredondo-González , Carmen de la Cuesta-Benjumea , Eva Abad-Corpa
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引用次数: 0

摘要

目的评估有护理专业人员参与的 65 岁及以上老年人跌倒预防计划的有效性:我们纳入了现有的全文随机临床试验,这些临床试验涉及在护士指导下预防 65 岁以上老年人在社区跌倒,并报告了此类跌倒的发生率。我们在 14 个数据库中对 2016 年至 2018 年期间的英文、法文、葡萄牙文和西班牙文出版物进行了广泛检索。论文质量由两人一组的审稿人使用 Cochrane 协作组织的偏倚风险 dominios 进行独立盲评。采用危险比来衡量跌倒发生率的效应大小。统计分析采用随机效应模型。研究的调节变量对效应大小的影响采用方差分析,每个调节变量类别的 95% CI 采用方差分析:结果:共选取了 31 项随机临床试验,参与人数达 25 551 人。最常见的干预类型是教育(57.1%),其次是多因素模型(37.1%)。与对照组相比,干预组的跌倒概率明显降低了13%(RR + = 0.87)。多因素干预(RR + = 0.89)和基于教育的干预(RR = +0.84)分别显著降低了11%和16%的跌倒概率:撇开出版偏差不谈,护士实施的预防计划可使跌倒发生率大幅降低 10%。由护士实施以教育为基础的多因素干预最为有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of nursing interventions in the prevention of falls in older adults in the community and in health care settings: A systematic review and meta-analysis of RCT

Objective

To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals.

Methods

We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016–2018 for publications in English, French, Portuguese and Spanish.

The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration.

The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category.

Results

A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+ = 0.87). Multifactorial (RR+ = 0.89) and education-based (RR = +0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively.

Conclusions

Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.

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