住院老年患者吞咽困难整合照护管理的最佳证据总结
Best Evidence Summary for Integrated Care Management of Dysphagia in Hospitalized Older Adults.
文献信息
| PMID | 42893158 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ruobing Yang |
| 作者单位 | Department of Anesthesia and Operating Theatre, Zhejiang Hospital, Hangzhou, Zhejiang, People's Republic of China. |
| 期刊 | Journal of multidisciplinary healthcare |
| SCI 分区 | Q2 |
| IF | 3.1 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评价并总结住院老年患者吞咽困难整合照护管理的最佳现有证据，为临床实践提供循证参考。
方法： 系统检索中英文数据库、临床实践指南库及专业协会网站。纳入的合格文献包括2015年1月1日至2026年1月31日期间发表的最佳实践建议、证据总结、临床实践指南、专家共识声明和系统评价。两名经过培训的研究人员使用标准化质量评价工具独立评价纳入文献的方法学质量，采用JBI证据预分级系统对证据进行分级，并对提取的研究结果进行综合。
结果： 共纳入28份文献，包括3份最佳实践建议、9份证据总结、3部临床指南、10份专家共识声明和3篇系统评价。由此综合得出43条推荐意见，涵盖七个关键领域：（I）多学科团队的建立，（II）吞咽困难筛查，（III）综合评估，（IV）整合照护管理，（V）康复干预，（VI）并发症的预防与管理，（VII）出院计划与随访。
结论： 本研究全面总结了住院老年患者吞咽困难整合照护管理的最佳证据，为规范临床路径和实践指南提供了坚实的证据基础。
英文摘要
PURPOSE: To evaluate and summarize the best available evidence on integrated care management of dysphagia in hospitalized older adults, providing an evidence-based reference for clinical practice.
METHODS: Evidence was systematically retrieved from Chinese and international databases, clinical practice guideline repositories, and professional association websites. Eligible publications included best practice recommendations, evidence summaries, clinical practice guidelines, expert consensus statements, and systematic reviews published between January 1, 2015, and January 31, 2026. Two trained researchers independently appraised the methodological quality of included literature using standardized quality assessment tools, graded the evidence using the JBI evidence pre-grading system, and synthesized the extracted findings.
RESULTS: A total of 28 documents were included, comprising 3 best practice recommendations, 9 evidence summaries, 3 clinical guidelines, 10 expert consensus statements, and 3 systematic reviews. From this synthesis, 43 recommendations were derived across seven key domains: (I) establishment of multidisciplinary teams, (II) dysphagia screening, (III) comprehensive assessment, (IV) integrated care management, (V) rehabilitation interventions, (VI) prevention and management of complications, and (VII) discharge planning and follow-up.
CONCLUSION: This study provides a comprehensive summary of best evidence for integrated care management of dysphagia in hospitalized older adults, offering a robust evidence base to inform standardized clinical pathways and practice guidelines.