1型糖尿病患者从儿科向成人医疗过渡管理的最佳证据总结
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女,硕士,护士

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Evidence summary for management of transition from pediatric to adult healthcare in patients with type 1 diabetes mellitus
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    目的 总结1型糖尿病患者从儿科向成人医疗过渡管理的相关证据,为临床过渡期医疗护理服务提供参考。 方法 按照“6S”金字塔证据模型,检索计算机决策系统、指南网站、专业学术网站及数据库中与1型糖尿病患者医疗过渡管理有关的文献,包括指南、证据总结、最佳实践信息手册、临床决策、专家共识、系统评价和随机对照试验。检索时限为建库至2022年8月31日。由2名研究者独立对文献质量进行评价,并对提取的证据进行证据分级。 结果 共纳入19篇文献,其中1篇临床决策、4篇指南、6篇专家共识、7篇系统评价、1篇随机对照试验。从一般原则、过渡准备、护理转移以及融入成人医疗4个方面总结出22条最佳证据。 结论 儿科和成人医疗服务提供者需对医疗过渡期的1型糖尿病患者进行全面分析,有针对性地选择证据,以便制订符合个体情况的过渡医疗护理方案,促进患者从儿科向成人医疗过渡,改善其过渡体验和健康结局。

    Abstract:

    Objective To summarize the best evidence for management of transition from pediatric to adult healthcare in patients with type 1 diabetes mellitus (T1DM) and to provide references for tansitional care. Methods According to the "6S" pyramid evidence model, the computer decision support systems, guideline websites, professional academic websites and databases were searched for literature related to management of transition from pediatric to adult care in patients with T1DM, in an effort to retrieve evidence from guidelines, evidence summaries, best practice information manuals, clinical decision, expert consensus, systematic reviews and randomized controlled trials (RCTs). The retrieval time was from the establishment of databases to August 31, 2022.The quality of the included literature was evaluated and graded. Results A total of 19 pieces of literature were eligible for inclusion. They were 1 clinical decision report, 4 guidelines, 6 expert consensus reports, 7 systematic reviews and 1 RCT. Totally 22 pieces of best evidence were summarized from 4 aspects of general principles, transition preparation, care transfer, and integration into adult health care. Conclusion Pediatric and adult healthcare providers should conduct a comprehensive analysis of patients with T1DM during the care transition period, and select targeted evidence, so as to formulate a heath care transition management program for patients with T1DM that meets individual conditions. Transition programs for patients with T1DM facilitate their transition from pediatric to adult care, and improve their transition experiences and health outcomes.

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王美娟,王金瑞,洪思思,茹一帆,高杨,颜梦雅,杨丹,徐亦虹,潘红英.1型糖尿病患者从儿科向成人医疗过渡管理的最佳证据总结[J].护理学杂志,2023,38(3):21-26

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  • 收稿日期:2022-09-07
  • 最后修改日期:2022-11-10
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  • 在线发布日期: 2023-12-29