主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
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卒中后吞咽困难识别与管理循证指南的系统评价

高尚谦 王芳 姜雨婷 韩柳 王晋芳 赵俊强 刘欣娟 郝玉芳   

  1. 北京中医药大学护理学院(高尚谦,姜雨婷,韩柳,王晋芳,赵俊强,刘欣娟,郝玉芳);北京中医药大学东直门医院(王芳)
  • 出版日期:2016-05-25 发布日期:2016-05-25
  • 基金资助:
    北京中医药大学青年教师专项课题(2015-JYB-QNJSZX009)

Evidence-based guidelines on identification and management of stroke dysphagia: a systematic review

  • Online:2016-05-25 Published:2016-05-25

摘要: 目的:评价卒中后吞咽困难识别与管理相关指南,比较各指南内容的异同,为临床循证决策及指南制定提供参考。方法:采用临床研究与评估工具(AGREE Ⅱ)对网站检索及数据库检索获取的相关循证指南进行质量评价,并分析各指南推荐内容的异同。结果:共纳入5 个循证指南,均来自国外;5 个指南在6 个领域的AGREE Ⅱ评价平均得分分别为范围和目的90.00%,参与人员77.77%,严谨性77.08%,清晰性85.93%,应用性52.78% 和独立性84.72%。指南总体质量评价为2 个A 级,3 个B 级。指南各推荐内容基本一致。结论:纳入的卒中后吞咽困难识别与管理循证指南总体质量较高,得分最低的指南“应用性”领域仍需要加强。我国按照国外AGREE Ⅱ标准制定循证指南尚有一定困难,但可以借鉴国外高质量的指南,在我国进行指南的本土化实践,以提高临床医护服务质量。

Abstract: Objectives: To systematically review the methodological quality of evidence-based guidelines on identification and management of stroke dysphagia, then to compare the differences and similarities of the contents of the included guidelines, and to provide references for evidence-based decision-making and the development of evidencebased guidelines. Methods: The methodological quality of included guidelines searched from websites and databases was evaluated according to the AGREE II instrument, and the differences and similarities between recommendations of included guidelines were compared. Results: A total of 5 evidence-based guidelines on identification and management of stroke dysphagia were included and they are all from abroad. To the overall quality, 2 of them were grade A and 3 of them were grade B. The average scores of guidelines in six domains of AGREE II were 90.00% (scope and purpose), 77.77%(stakeholder involvement), 77.08% (rigor of development), 85.93% (clarity of presentations), 52.78% (applicability), and 84.72% (independence), respectively. The recommendations of included guidelines were almost consistent. Conclusion:The overall quality of included guidelines was high. The lowest domain scores of "applicability" need to be improved.China's development of evidence-based guidelines in accordance with the standard of foreign AGREE II still have a certain gap, but there are still some high-quality foreign guidelines which could be tailored and implemented to the local context in order to improve the clinical quality of care.