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Objective:To search and summarize the evidence for the non-pharmacological management of delirium of critically ill patients in PICU, and to provide evidence-based guidance for clinical practice.Methods:According to the "6S" evidence pyramid model, we searched computerized decision support system, websites of guidelines, and databases, and obtained the guidelines, clinical decisions, systematic reviews, and evidence summaries.After screening the articles, two researchers independently appraise articles using validated tools, and finally formed the evidence summary of delirium non-pharmacological management of critically ill patients in PICU.Results:Totally six articles were included for the evidence synthesis, including three guidelines, two systematic reviews, and one expert advice.Twenty pieces of evidence including four aspects were summarized, namely delirium screening, risk prediction, non-pharmacological prevention and management strategies, health care provider education and departmental standardization.Conclusion:The evidence summarized in this study can provide a reference to health care professionals.When we apply this evidence in the clinical setting, we should adapt it accordingly to the specific clinical setting to improve the effectiveness of the evidence.
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Objective:To summarize the best evidence of pulmonary rehabilitation in adult patients undergoing upper abdominal surgery and provide evidence-based basis for clinical intervention.Methods:Systematically searched clinical decisions, guidelines, expert consensus, evidence summary, systematic review and randomized controlled trial studies on pulmonary rehabilitation for patients undergoing upper abdominal surgery in UpToDate, Cochrane Library, Web of Science, PubMed, Embase, CINAHL, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, National Comprehensive Cancer Network, Guidelines International Network, Medlive, British Thoracic Society, European Respiratory Society, American Association for Cardiovascular and Pulmonary Rehabilitation, Canadian Thoracic Society, American Thoracic Society, WanFang Database, China National Knowledge Infrastructure, VIP Database, and China Biology Medicine. The retrieval time limit was from March 11, 2012 to March 11, 2022. Evidence was extracted, summarized and recommended after strict evaluation of literature quality.Results:A total of 19 pieces of literature were eligible for inclusion. They were 2 clinical decisions, 4 expert consensuses, 4 systematic evaluations, and 9 randomized controlled studies.The best evidence included 22 recommendations in 7 dimensions, namely pulmonary rehabilitation team, patient assessment, sports training, respiratory muscle training, drug rehabilitation, health education and quality control.Conclusions:Summary of the best evidence of pulmonary rehabilitation in patients undergoing upper abdominal surgery can provide evidence-based guidance for clinical intervention, but medical staff should also develop personalized training programs according to the actual situation of patients when applying the evidence.
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Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.
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Objective:To search for evidence of capacity management in patients undergoing extracorporeal membrane oxygenation support therapy, and summarize the evidence to provide evidence-based basis for medical staff to evaluate and manage the capacity of such patients.Methods:This study was an evidence-based nursing study. Based on the 6S evidence model, relevant evidence on patient volume management in extracorporeal membrane oxygenation support therapy was systematically searched for relevant evidence on patient volume management in extracorporeal membrane oxygenation support therapy from top to bottom, including UpToDate, the National Guidelines Library of the United States, the Scottish Interhospital Guidelines Network, the Medical Guidelines Network, the Extracorporeal Life Support Organization website, Cochrane Library, PubMed, CINAHL, Wanfang, China National Knowledge Infrastructure, and the Chinese Biomedical Literature Database. Based on the inclusion criteria, clinical guidelines, expert consensus, clinical decision-making, evidence summary, and systematic evaluation were selected for literature quality evaluation to extract the best evidence. The search period was from April 10, 2017 to April 10, 2022.Results:A total of 11 articles were included and 20 pieces of evidence were extracted, which were categorized into four categories: extracorporeal membrane oxygenation team composition and personnel qualifications, evaluation and monitoring, capacity management objectives, and capacity management measures.Conclusions:Based on a large amount of evidence of extracorporeal membrane oxygenation support for patient capacity management, this study can provide a reference basis for clinical workers to develop extracorporeal membrane oxygenation support treatment capacity management plans.
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Objective:To comprehensively retrieve and summarize the best evidence on the prevention of position-related nerve injury in adult patients undergoing general anesthesia, in order to provide evidence-based guidance for standardized position management during general anesthesia surgery in adults.Methods:Clinical decision-making, guidelines, evidence summaries, best practice, practice advisories, systematic reviews, expert consensuses were systematically search in UpToDate, BMJ Best Practice, Guidelines International Network (GIN), Canadian Medical Association: Clinical Practice Guideline(CMA Infobase), National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence(NICE), Cochrane Library, PubMed, CNKI, Wanfang, and related websites. The literature retrieval period was from the database construction to September 30,2022. The guidelines were independently assessed by 4 researchers, and the remaining literature was independently evaluated by 2 researchers. The literature that met the criteria was extracted. Finally, the expert meeting integrated the evidence and summarized the evidence topics.Results:A total of 17 articles were included, including 6 clinical decision-making, 3 guidelines, 2 practice advisories,5 systematic reviews, and 1 expert consensus. A total of 32 pieces of best evidence and 5 evidence topics were formed: personnel placement, perioperative evaluation, points of surgical position, key points in special surgery or situation, other general principles.Conclusion:This study summarized the best evidence for the prevention and management of surgical position related nerve injuries, and provides a scientific theoretical reference for postural management of adult patients undergoing operation with general anesthesia, to reduce the incidence of nerve injuries related position.
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Objective:To evaluate and summarize the best evidence for exercise intervention in patients with hypertension, and to provide the basis for clinical medical workers to manage hypertension.Methods:We searched UpToDate, BMJ Best Practice, the Cochrane Library, the International Guideline Collaborative Network to collect guidelines, systematic evaluation, and evidence summary. The retrieval time was from database establishment to June 1st 2022. Two researchers independently conducted literature quality evaluation and extracted evidence from the included literature.Results:A total of 13 articles were included, including 10 guidelines, 1 expert consensus and 2 Meta analysis. A total of 23 pieces of best evidence were collected, mainly involving 8 aspects, including exercise principles, exercise assessment, exercise environment, pre-exercise preparation, exercise program, post-exercise collation, tracking and review, exercise compliance.Conclusions:Exercise has a positive effect on improving blood pressure in patients with hypertension. The suggestions summarized in this study can be tried to guide clinical practice.
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Objective:To retrieve, obtain and summarize the best evidence for the prevention of recurrence in patients with diabetic foot, and to provide reference for clinical practice.Methods:According to the "6S" model of evidence-based resources, JBI, UpToDate, BMJ Best Practice, Cochrane Library, International Working Group on the Diabetic Foot, International Diabetes Federation, National Istitute for Health and Clinical Excellence, PubMed, EmBase, China National Knowledge Internet, Wanfang and China Biology Medicine disc were searched by computer for the prevention of recurrence of diabetic foot patients. The retrieval time limit was from the establishment of the database to April 2022. Two researchers independently evaluated the included literature and extracted the literature that met the quality standards.Results:Totally 12 articles were included at last, including 5 guidelines, 3 expert consensus and 4 Meta-analysis. From the six dimensions of the necessity and risk factors of recurrence prevention in diabetic foot patients, decompression brace prevention, surgery and wound management prevention, nutritional therapy prevention, health education and lifestyle prevention, monitoring and analysis, 18 pieces of best evidence were summarized.Conclusions:The best evidence for the prevention of recurrence of diabetic foot patients was summarized to provide evidence-based basis for management decision makers and decision implementers to prevent recurrence of diabetic foot. In the process of practice, medical workers should also fully evaluate the promoting factors and hindering factors in order to ensure that evidence can be better applied to clinical practice and serve patients.
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Objective:To search, select and integrate the available evidence for the intracranial pressure management in patients with hemorrhagic stroke, to provide evidence-based references for clinical practice.Methods:According to the "6S" pyramid model, all literature on the management of intracranial pressure in patients with hemorrhagic stroke was retrieved from the websites and database including UpToDate, BMJ Best Practice, Cochrane Library, PubMed, Embase, relevant guideline net works and association websites as well as National stroke database,Yimaitong, CBM, CNKI, Wanfang Data, VIP and other databases, including Clinical decision-making, guidelines, evidence collection, systematic evaluation, expert consensus and evidence-related original research. The search time limit was from the establishment of the database to June 10, 2022. Two researchers independently evaluated the literature quality. The qualified literature was extracted.Results:A total of 19 pieces of literature were included, including 3 clinical decision-making, 5 guidelines, 3 systematic reviews, 4 expert consensuses, 3 randomized controlled studies and 1 case series study. Finally, 23 pieces of best evidence were summarized, involving 5 aspects such as assessment and monitoring, management goals, management scheme, treatment selection and methods, risk management.Conclusions:Active intracranial pressure management can improve the prognosis of patients with hemorrhagic stroke. It is recommended that health care professionals should select evidence in combination with specific clinical situations and formulate individualized intracranial pressure management programs.
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Objective:To summarize the relevant evidence of motor rehabilitation of stroke at home and abroad, so as to provide reference for medical staff to carry out motor rehabilitation.Methods:The related evidence on exercise management for patients with stroke in BMJ Best practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, National Guideline, American Heart Association/American Stroke Association, European Stroke Organization, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Canadian Medical Association, American Association of Critical Care Nurses, National Stroke Foundation, Chinese Stroke Association, Medlive, Cochrane library, PubMed, Web of Science, Embase, OVID, Medline, China National Knowledge Infrastructure, Wanfang, VIP, SinoMed were searched by computer. The retrieval time limit was from 2012 to June 30, 2022. Two to four investigators independently assessed the quality of the included article, and extracted and summarized the evidence that met the quality standards.Results:A total of 22 articles were included, including 5 guidelines, 2 summary of evidence, 2 expert consensus, and 13 systematic evaluations. A total of 42 pieces of evidence related to exercise rehabilitation were extracted and integrated, including 11 aspects such as multidisciplinary teams, exercise goals, exercise timing, exercise evaluation, exercise venue, exercise style, exercise intensity, exercise time and frequency, safety monitoring, exercise behavior maintenance, and health education.Conclusions:The best evidence summarized in this study can provide a reference for clinical medical staff to implement exercise rehabilitation, but in clinical practice, it is necessary to select and apply evidence in a targeted manner in combination with specific circumstances, so as to improve the safety and effect of exercise rehabilitation.
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Objective:To integrate the best evidence of non-drug intervention of urinary incontinence in elderly women and to formulate practical recommendations.Methods:In this systematic review study, using “elderly woman”,“urinary incontinence”,“bladder training”,“pelvic floor muscle training”,“enuresis”,“leakage of urine” as the key words, the 6S evidence resource pyramid model was used to search in British Medical Journal best practice, Uptodate, World Health Organization, Guidelines International Network, National Institute for Health and Care Excellence, Chinese Medical Association, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, The Joanna Briggs Institute (JBI), New Zealand Guidelines Group, Polish Society of Gynecologists and Obstetricians, PubMed, Embase, Medline, Web of Science, SinoMed, China National Knowledge Infrastructure, WanFang Data, etc. The evidence retrieved included evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review, etc. Data were retrieved from January 1, 2017 to May 1, 2022, and collated from May 2, 2022 to May 25, 2022. Two researchers independently evaluated the quality of literature and extracted data using the AGREE Ⅱ and JBI evidence-based health care center assessment tools. The JBI evidence-based health care center′s evidence pre-rating system and evidence recommendation rating system were applied to rank the evidence; and under the guidance of the evidence structure of JBI, the strength of evidence recommendation was determined and the best evidence was extracted and summarized in combination with the study group discussion and expert opinion.Results:A total of 9 articles were retrieved, including 7 guidelines and 2 systematic reviews; and 6 guidelines were classified as Grade A and 1 as grade B; both 2 systematic reviews were rated as Grade A; 84% (27/32) of the items were evaluated as “Yes”. Evidence were summarized as 34 pieces of best evidence from 6 dimensions, including “overall recommendation, evaluation of type and degree of urinary incontinence, lifestyle change, behavioral therapy, prevention of precipitating factors, intervention in special population”; the flow chart of screening, evaluation, special symptoms, life style and behavior therapy was combed, and the practical suggestions were formed.Conclusions:The overall quality of the literature on non-drug intervention of urinary incontinence in elderly women is high, and the level of evidence is high. Early identification of urinary incontinence types and assessment of disease severity, lifestyle changes, avoidance of predisposing factors and behavioral therapy are the key to non-drug treatment of urinary incontinence in those patients.
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Objective:To explore the optimal evidence for the nursing management of limb spasm in patients with spinal cord injury.Methods:Based on the "6S" evidence model, the databases including CNKI, Wanfang, PubMed and Cochrane Library, the guideline websites such as the National Guideline Clearinghouse, Guidelines International Network and Registered Nurses′ Association of Ontario, and the websites of professional associations such as the Royal College of Physicians, American Spinal Injury Association and Canadian Spine Association were systematically searched. Search period of each database was set from the year of inception until July 2022. Two investigators independently screened the literatures related to the management of limb spasm in patients with spinal cord injury, and conducted quality evaluation and evidence recommendation level evaluation.Results:Totally 17 literatures consisting of 6 guidelines, 3 expert consensuses, 5 systematic reviews, 2 evidence summaries, and 1 clinical decision were included. Moreover, 30 pieces of evidence were summarized from 3 aspects, including evaluation and identification, drug therapy (chemical denervation, and oral medication), rehabilitation training (hydrotherapy, electrical stimulation, magnetic stimulation, vibration therapy, heat and cold therapy, body position, and exercise therapy).Conclusion:Nursing staff can set up a multidisciplinary team according to the clinical environment and take into consideration of the characteristics of spinal cord injury patients to provide personalized interventions involving evaluation and identification, drug therapy, rehabilitation training, etc., so as to alleviate the degree of limb spasm.
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Objective:To evaluate and summarize the best evidence of energy and protein intake targets and calculation in adult critically ill patients, and to provide evidence-based basis for critical nutrition management.Methods:Evidence related to energy and protein intake targets and calculation of adult critically ill patients, including guideline, expert consensus, systematic review and evidence summary, were systematically searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Web of Science, SinoMed, Medive, China National Knowledge Infrastructure, Wanfang database, VIP database, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), and Society of Critical Care Medicine (SCCM) from January 2012 to June 2022. Two researchers independently evaluated the quality of the included literatures using the JBI Evidence-based Health Care Center evaluation tool and the Appraisal of Clinical Practice Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), extracted and summarized the best evidence for the nutritional intake goal and calculation of adult critically ill patients, and described the evidence.Results:A total of 18 literatures were included, including 5 clinical guidelines, 8 expert consensus, 3 systematic reviews and 2 evidence summaries. After literature quality evaluation, 18 articles were all enrolled. The evidence was summarized from the four aspects, including energy target calculation method, dose body weight, energy and protein intake target, and calculation method, 24 pieces of the best evidence were finally formed.Conclusions:The best evidence of energy and protein intake targets and calculation for critically ill patients was summarized based on evidence-based. Clinical medical staff can choose indirect calorimetry to calculate energy goals when equipment is available. Patient's height, body weight should be recorded accurately, dose body weight can be determined by body mass index (BMI). Meanwhile, blood urea nitrogen (BUN) loss, fat-free body weight, simple formulas and other methods should be used to continuously evaluate and adjust protein intake targets, to achieve the purpose of optimizing intensive nutrition support.
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Objective:To establish the best evidence-based approach for early fluid resuscitation management in patients with severe acute pancreatitis (SAP).Methods:A literature search was conducted utilizing evidence-based nursing methods to identify relevant evidence on the management of early fluid resuscitation in patients with SAP. The search followed the hierarchical order of the " 6S" evidence pyramid, including databases such as China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (SinoMed), Wanfang Database, UpToDate, NICE, RNAO Guidelines Network, Pancreatology International, WHO Association Website, JBI, Cochrane, PubMed, EMBASE, and CINAHL. The search was limited to articles published from the establishment of each database to March 2022. The literature quality evaluation tools and an evidence pre-grading system from the JBI Evidence-Based Health Care Center were employed to assess the quality of the literature included in the study. Additionally, the FAME structure was utilized to evaluate the feasibility, appropriateness, clinical significance, and validity of the evidence.Results:Nine articles were finally incorporated into the analysis, including four guidelines, one evidence summary, two systematic reviews, and two expert consensus articles. 21 pieces of evidence pertaining to early fluid resuscitation management in patients with SAP was summarized, encompassing five key aspects: resuscitation timing, type of fluid infusion, total volume and speed of fluid infusion, dynamic monitoring, and fluid resuscitation goals. It was advisable for patients diagnosed with SAP to promptly receive fluid resuscitation, ideally within 72 hours of diagnosis. The initial choice for fluid resuscitation was lactated Ringer′s solution, with the addition of human albumin as a supplementary colloid solution. The quantity of fluid administered within the first 24 hours of rehydration should constitute approximately 33.3% of the total rehydration volume within the 72 hours time-frame. In the case of patients experiencing early shock or dehydration, it was advised that the fluid rate administered should be 5-10 ml·kg -1·h -1 within the first 24 hours of admission. Additionally, an infusion of 20 ml/kg of fluid can be administered within the initial 30-45 minutes. It was recommended to assess the adequacy of early fluid resuscitation every 4-6 hours, ensuring that the resuscitation objective could meet at least two of the following criteria: urine output of 0.5-1 ml·kg -1·h -1, mean arterial pressure of 65-85 mmHg, central venous pressure of 8-12 mmHg, heart rate below 120 beats/min, central venous oxygen saturation of at least 70%, and a decrease in hematocrit levels to 30%-35%. Conclusions:The most compelling evidence supporting the implementation of early fluid resuscitation management in patients with SAP is derived from an evidence-based nursing approach, which could effectively improve patient care outcomes.
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Objective:To search and analyze the relevant evidence of exercise rehabilitation in heart transplant patients and summarize the best evidence.Methods:The best practice information book, evidence summary, guidelines, expert consensus and systematic review of exercise rehabilitation for heart transplant patients in CNKI, Wanfang, CBM, PubMed, Embase, Cochrane Library, UpToDate, BMJ Best Practjce, National Institute for Health and Clinical Excellence (NICE), International Guidelines Network (GIN), Scottish Intercollegiate Guidelines Network (SIGN), New England Medicine (NEJM), Joanna Briggs Institute (JBI) Evidence-based Health Care Center in Australia, American Health Care Policy Research Institute (AHRQ), American Heart Association (AHA), American College of Cardiology (ACC), American Association for Cardiopulmonary Rehabilitation (AACVPR), European Society of Cardiology (ESC), International Society for Heart and Lung Transplantation (ISHLT) were searched by computer.Results:A total of 10 articles were included, including 1 clinical decision, 2 guidelines, 1 expert consensus and 6 systematic reviews; after evaluation, a total of 21 best evidences in 7 aspects: exercise effectiveness, exercise timing, exercise assessment, exercise modality, exercise duration, pre-habilitation, exercise compliance were summarized.Conclusions:This study summarizes the best evidence of exercise rehabilitation in patients undergoing heart transplantation and provides a reference for medical staff to develop exercise rehabilitation programs for patients after heart transplantation.
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Objective:To summarize the best evidence for intermittent pneumatic compression devices in preventing venous thromboembolism for trauma patients.Methods:According to "6S" evidence model, computer evidence retrieval was carried out. Guidelines, clinical decisions, evidence summaries, expert consensuses, and systematic reviews regarding intermittent pneumatic compression in preventing of venous thromboembolism for trauma patients were considered. The retrieval time limit was from the establishment of the database to October 31, 2021. Two researchers independently appraised articles, and extracted data for eligible studies.Results:A total of 21 articles were enrolled, including 13 guidelines, 1 clinical decision, 1 evidence summary, 2 expert consensuses, 4 systematic reviews. Totally 27 items of best evidence were summarized from four aspects: pretherapeutic evaluation, contraindications and applicable conditions, therapeutic strategies, training and education.Conclusions:This study summarized the best evidence of using intermittent pneumatic compression devices to prevent venous thromboembolism for trauma patients, which can provide evidence-based practice bases for nurses to implement scientific and effective standardized management of mechanical thromboprophylaxis. It is necessary to select evidence according to clinical practice and patients ′ wishes, so as to improve the effectiveness of using IPC in preventing thrombosis.
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Objective:To search, evaluate and summarize the best evidence for non-pharmaceutical therapy of cancer-related fatigue in cancer patients.Methods:According to the "6S" evidence model, systematically searched relevant domestic and foreign guideline networks and databases to collect relevant evidences, including clinical decision support, guidelines, evidence summaries, and systematic reviews. Retrieval time from the establishment of the database to August 2021. After evaluating the quality of the literature, we extracted and summarized relevant evidence.Results:A total of 18 articles were included in this study, including 1 clinical decision support, 4 clinical practice guidelines, 5 evidence summarie and 8 systematic reviews. 25 pieces of best evidence were summarized, involving non-pharmacological interventions in 7 aspects: health education, exercise intervention, psychosocial intervention, traditional Chinese medicine therapy, nutritional support, sleep therapy and bright white light therapy.Conclusions:It is recommended that medical staff should combine clinical practice, scientifically select the best evidence and use evidence-based management scheme for cancer-related fatigue to reduce cancer-related fatigue and improve patients′ life quality.
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Objective:To summarize the best evidence for the prevention of medical device related pressure injuries in patients in ICU, and to provide a basis for clinical nursing practice.Methods:Using evidence-based method and computer 6S evidence model, the relevant literature was retrieved. The resource types included clinical guidelines, evidence summaries, systematic reviews and expert consensus. The retrieval time was from the establishment of the databases to January 2021. Three researchers who received evidence based nursing training independently evaluated various types of literature, and extracted evidence from literature that met inclusion criteria.Results:A total of 11 articles were included with 8 guidelines, 1 systematic review, 1 evidence summary, and 1 expert consensus. The 24 best evidences related to risk assessment, skin assessment and cleaning, selection and wearing of medical devices, preventive use of dressings, and education and training were summarized.Conclusions:This study summarized the clinical practice basis for the prevention of medical device related pressure injuries in patients in ICU, which can provide scientific and effective theoretical guidance for clinical nursing staff to implement changes in practice. And it is recommended that the evidence should be combined with the clinical reality when using evidence. Analyze the facilitating factors and obstacles in the process of using evidence and formulate reform strategies suitable for clinical transformation, and then apply them to daily clinical work to improve the quality of nursing work.
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ObjectiveTo summarize and evaluate the best evidence for postpartum physical activity and exercise regimens. MethodsLiteratures of postpartum sports and exercise programs were searched from JBI, UpToDate, Cochrane Library, International Federation of Gynecology and Obstetrics (FIGO), The Agency for Healthcare Research and Quality(AHRQ), Royal College of Obstetricians and Gynaecologists (RCOG), American Collage of Obstetricians and Gynecologists (ACOG), Registered Nurses' Association of Ontario (RNAO), World Health Organization (WHO), Fitness Australia (FA), National Institute for Health and Care Excellence (NICE), Web of Science, PubMed, CINAHL, Medlive, CNKI, and Wanfang Data, from database inception to October, 2021. Two researchers independently evaluated the literature quality according to the tool of the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE Ⅱ), A Measurement Tool to Assess Systematic Reviews (AMSTAR), and Joanna Briggs Institute Critical Appraisal Checklist. ResultsA total of 15 articles were selected, including four randomized controlled trials, four systematic reviews, one cross-sectional study, one evidence summary, four guidelines, and one expert consensus. A total of 28 pieces of evidence were summarized, including the significance of postpartum physical activity and exercise, obstacle factors, assessment, exercise style, intensity and timing, and precautions. ConclusionKnowledge of exercise after delivery is important to promote women's health and quality of life. It is recommended that the evidence be screened on a case-by-case basis and that an individualized programme of physical activity and exercise be developed.
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To evaluate and summarize the evidence of diet and physical activity management in patients with metabolic syndrome (MS). BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, Agency for Healthcare Research and Quality (AHRQ) network, National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Medlive, Registered Nurses' Association of Ontario (RNAO) network, American Diabetes Association (ADA) network, New Zealand Guideline Group (NZGG) network, Canadian medical association clinical practice guidelines network, PubMed, EmBase, Web of Science, CINAHL, Cochrane Library, CNKI, China Science and Technology Journal Database, Wanfang Knowledge Data Service Platform and Chinese biomedical database were searched systematically to obtain guidelines, evidence summary, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on diet and physical activity management in patients with MS. The retrieval period is from the establishment of database to November 2021. Two researchers with evidence-based medicine background evaluated the quality and evidence level of the included literature. A total of 36 articles met the criteria, including 3 guidelines, 5 expert consensus, 1 clinical decision and 27 systematic reviews. We summarized 49 pieces of evidence related to diet and physical activity in patients with MS, involving 15 aspects, namely diet goals, diet patterns, diet time, carbohydrate intake, fat intake, fiber intake, salt intake, fruits, vegetables and grains intake, coffee intake, effects of diet, principle of physical activity, intensity, form, time of physical activity, effects of physical activity, physical activity prescription of patients with MS and cardiovascular disease, and the joint effects of diet and physical activity. Diet and physical activity management can effectively improve the health outcomes of patients with MS. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.
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Humans , Canada , Consensus , Diet , Exercise , Metabolic Syndrome/therapyABSTRACT
Objective:To search, evaluate and summarize the evidence on prediabetes management in high-risk population with gestational diabetes mellitus (GDM).Methods:Two researchers independently screened the evidence according to the inclusion criteria and exclusion criteria. The quality of the included evidence was evaluated by the clinical guideline research and evaluation system (AGREE Ⅱ). The quality of the evidence and the strength of recommendation were graded by the GRADE system. According to the clinical nursing practice guidelines for gestational diabetes mellitus, the recommendations for GDM high-risk groups were extracted.Results:A total of 14 pieces of evidence were included, including 4 guidelines, 2 consensus, 5 practice guidelines and 3 diagnosis and treatment standards. 29 pieces of recommendations for prediabetes management of high-risk population with gestational diabetes mellitus were summarized from five aspects, including disease risk assessment, prenatal examination guidance, management objectives of gestational weight and blood glucose, diet guidance and exercise guidance.Conclusion:The evidence of prediabetes management of high-risk population with gestational diabetes mellitus is scientific and reliable.