老年造口术患者最佳家庭自我管理的循证总结

摘要(中文译文)

随着人口老龄化及严重肠道疾病发病率上升，老年造口患者面临居家自我管理挑战且照护能力不足，而其特定需求缺乏系统整合的证据，因此有必要总结最佳证据以支持临床照护并改善其生活质量。本研究系统进行了计算机文献检索，以识别聚焦老年造口患者居家造口自我管理的研究。检索覆盖多种来源，包括国内外指南平台、相关机构官方网站及主要学术数据库。纳入文献类型包括临床实践指南、临床决策工具、专家共识、系统评价及证据总结。检索资源中文献检索时间范围为2015年1月至2025年10月。共纳入15项高质量研究，涵盖六大核心领域：自我管理目标、造口评估、心理调适、饮食管理、行为管理及药物管理。本研究共总结36条证据，填补了老年造口患者居家造口自我管理系统整合证据的空白。然而，鉴于该证据来源于医疗体系与情境各异的多个国家，其临床应用应结合该人群的具体临床状况和个体需求进行调整。未来研究应聚焦于开发更具针对性的循证干预措施，以优化老年造口患者的居家造口自我管理。本证据总结遵循复旦大学循证护理中心制定的证据总结报告规范，该规范基于乔安娜布里格斯研究所（JBI）证据总结方法学框架。报告流程包括确立循证问题、文献检索、文献筛选、质量评价、证据综合与分级及实践建议制定。本研究已在复旦大学循证护理中心证据总结注册系统注册，题目为“老年造口患者居家最佳自我管理的循证总结”，注册号为ES20246036。本基于文献的证据总结未招募直接现场参与的患者或公众参与者。所有患者相关体验和实践观点均从纳入的已发表研究中提取和整合，以确保老年造口患者居家最佳自我管理证据的适用性。注册号：ES20246036。

Abstract

Given the aging population and increasing incidence of severe intestinal diseases, elderly ostomy patients face home self-management challenges with insufficient care capacity, and the lack of systematically integrated evidence for their specific needs necessitates summarizing the best evidence to support clinical care and improve their quality of life. A computerized literature search was systematically performed to identify studies focusing on home stoma self-management among elderly ostomy patients. The search was conducted across multiple sources, including domestic and international guideline platforms, official websites of relevant institutions, and major academic databases. Eligible literature included clinical practice guidelines, clinical decision-making tools, expert consensus statements, systematic reviews, and evidence summaries. Literature was searched from January 2015 to October 2025 in the following resources. A total of 15 high-quality studies were included, encompassing six core domains: self-management goals, stoma assessment, psychological adjustment, dietary management, behavioral management and medication management. A total of 36 pieces of evidence were summarized in this study, which fills the gap of systematically integrated evidence for home stoma self-management in elderly ostomy patients. However, given that this evidence was derived from diverse countries with diverse healthcare systems and contexts, its clinical application should be tailored to the specific clinical conditions and individual needs of this population. Future research should focus on developing more targeted, evidence-based interventions to optimize home stoma self-management for elderly ostomy patients. This evidence summary followed the reporting specifications for evidence summaries developed by the Fudan University Center for Evidence-based Nursing, which were based on the methodological framework for evidence summaries produced by the Joanna Briggs Institute (JBI). The reporting process included establishing the evidence-based question, literature retrieval, literature screening, quality appraisal, evidence synthesis and grading, and development of practice recommendations. This study was registered in the evidence summary registration system of Fudan University Center for Evidence-based nursing under the title "Evidence-based summary of optimal home self-management for elderly ostomy patients" with the registration number ES20246036. No direct on-site patient or public participants were recruited for this literature-based evidence summary. All patient-related experiences and practical perspectives were extracted and integrated from the included published studies to ensure the applicability of the optimal home self-management evidence for elderly ostomy patients. Identifier ES20246036.

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