José Lucas Sena da Silva, Lorena Azi, Kan Ding, Luiz Eduardo Ritt, Juliana Caldas
{"title":"非药物干预预防老年外科患者谵妄：随机对照试验的网络荟萃分析。","authors":"José Lucas Sena da Silva, Lorena Azi, Kan Ding, Luiz Eduardo Ritt, Juliana Caldas","doi":"10.3928/00989134-20250626-01","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The current meta-analysis aimed to evaluate the effectiveness of nonpharmacological interventions in preventing delirium among older adult surgical patients.</p><p><strong>Method: </strong>Randomized controlled trials (RCTs) examining nonpharmacological approaches were selected. A meta-analysis was performed using random-effect models to calculate standard mean differences and 95% confidence intervals (CI).</p><p><strong>Findings: </strong>Twelve RCTs (<i>N</i> = 3,829) met inclusion criteria. Nonpharmacological interventions significantly reduced delirium incidence (OR [odds ratio] = 0.57, 95% CI [0.49, 0.66]). Multicomponent (OR = 0.6, 95% CI [0.49, 0.75]) and single-component (OR = 0.53, 95% CI [0.42, 0.66]) interventions were effective. Network meta-analysis revealed that the multicomponent intervention \"Family HELP\" demonstrated significant superiority over four other interventions (OR = 0.11, 95% CI [0.04, 0.33]; p-score = 0.911).</p><p><strong>Conclusion: </strong>Nonpharmacological interventions were found to effectively prevent delirium among older adult surgical patients, with the Family HELP intervention being the most effective. These interventions should be integrated into nursing care guidelines to enhance patient-centered care and experience.</p>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":" ","pages":"20-29"},"PeriodicalIF":1.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nonpharmacological Interventions Prevent Delirium in Older Adult Surgical Patients: A Network Meta-Analysis of Randomized Controlled Trials.\",\"authors\":\"José Lucas Sena da Silva, Lorena Azi, Kan Ding, Luiz Eduardo Ritt, Juliana Caldas\",\"doi\":\"10.3928/00989134-20250626-01\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The current meta-analysis aimed to evaluate the effectiveness of nonpharmacological interventions in preventing delirium among older adult surgical patients.</p><p><strong>Method: </strong>Randomized controlled trials (RCTs) examining nonpharmacological approaches were selected. A meta-analysis was performed using random-effect models to calculate standard mean differences and 95% confidence intervals (CI).</p><p><strong>Findings: </strong>Twelve RCTs (<i>N</i> = 3,829) met inclusion criteria. Nonpharmacological interventions significantly reduced delirium incidence (OR [odds ratio] = 0.57, 95% CI [0.49, 0.66]). Multicomponent (OR = 0.6, 95% CI [0.49, 0.75]) and single-component (OR = 0.53, 95% CI [0.42, 0.66]) interventions were effective. Network meta-analysis revealed that the multicomponent intervention \\\"Family HELP\\\" demonstrated significant superiority over four other interventions (OR = 0.11, 95% CI [0.04, 0.33]; p-score = 0.911).</p><p><strong>Conclusion: </strong>Nonpharmacological interventions were found to effectively prevent delirium among older adult surgical patients, with the Family HELP intervention being the most effective. These interventions should be integrated into nursing care guidelines to enhance patient-centered care and experience.</p>\",\"PeriodicalId\":15848,\"journal\":{\"name\":\"Journal of gerontological nursing\",\"volume\":\" \",\"pages\":\"20-29\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of gerontological nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3928/00989134-20250626-01\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of gerontological nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/00989134-20250626-01","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/7 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Nonpharmacological Interventions Prevent Delirium in Older Adult Surgical Patients: A Network Meta-Analysis of Randomized Controlled Trials.
Purpose: The current meta-analysis aimed to evaluate the effectiveness of nonpharmacological interventions in preventing delirium among older adult surgical patients.
Method: Randomized controlled trials (RCTs) examining nonpharmacological approaches were selected. A meta-analysis was performed using random-effect models to calculate standard mean differences and 95% confidence intervals (CI).
Findings: Twelve RCTs (N = 3,829) met inclusion criteria. Nonpharmacological interventions significantly reduced delirium incidence (OR [odds ratio] = 0.57, 95% CI [0.49, 0.66]). Multicomponent (OR = 0.6, 95% CI [0.49, 0.75]) and single-component (OR = 0.53, 95% CI [0.42, 0.66]) interventions were effective. Network meta-analysis revealed that the multicomponent intervention "Family HELP" demonstrated significant superiority over four other interventions (OR = 0.11, 95% CI [0.04, 0.33]; p-score = 0.911).
Conclusion: Nonpharmacological interventions were found to effectively prevent delirium among older adult surgical patients, with the Family HELP intervention being the most effective. These interventions should be integrated into nursing care guidelines to enhance patient-centered care and experience.
期刊介绍：
The Journal of Gerontological Nursing is a monthly, peer-reviewed journal publishing clinically relevant original articles on the practice of gerontological nursing across the continuum of care in a variety of health care settings, for more than 40 years.
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