| Objective 1.This study retrieved domestic and foreign literatures on the frailty status of elderly,frailty assessment tool and frailty intervention in recent years,understanding relevant assessment tools for frailty,systematic review status of frailty in elderly at home and abroad and effective of frailty intervention,aiming at providing a theoretical basis for research on frailty status and influencing factors.2.This study retrieved domestic and foreign literatures on effect of frailty intervention in elderly,in order to lay a solid foundation for frailty intervention for frailty elderly in China and to reduce the incidence of elderly frail,and prevent other adverse consequences caused by frailty(falls,hospitalization,long-term care,and death).MethodsBased on systematic review of evidence-based nursing,retrieval strategies were developed to search literatures about frailty status,intervention for frailty elderly and frailty elderly with diseases from Pubmed,Embase and Medline database in 2006~2016 years,as well as CNKI,VIP and Wanfang.In criteria standard was developend and the quality of the literatures was evaluated.Then the data were extracted and Stata12.0 and Revman5.2 software were used for meta analysis.At last,descriptive analysis were prepared for literatures that couldn't be consolidated.Result 1.Status of fraility in elderly Searching literatures with retrieval formul,a total of 42 literatures on frailty prevalence were included with 33 literatures of high quality and 9 literatures of medium quality.Research results:(1)FP is the most common frailty assessment tool.SOF scale can be used for rapid screening of frailty.FRAIL-NH scale is suitable for elders with long term care.(2)Community elderly frailty incidence was 11.4% with FP,and a higher incidence of prefrail elderly was 44.1%;Community elderly frail incidence rate was 20.7% with SOF.The incidence of frailty elderly in hospital was 43.6% with FP,as well as incidence of prefrail 46.2%;The incidence of elderly with long term care was respectively 48.4% and 37.9% with FRAIL-NH and FP.(3)Age,gender,marital status,educational level,drug use,income,comorbidity and cognitive impairment were respetivly affecting factors of frail elderly.2.Effect of frailty intervention in elderly Searching literatures with retrieval formul,a total of 26 literatures were included with 15 high quality literatures,7 medium quality literatures,and 5 low quality literatures.The results were as follows:(1)Nutrition intervention could not improve the physiological function of the frail elderly.(2)Exercise intervention could significantly enhance the outcome of frailty elderly,including the moving ability(TUGT),balance ability,self rating scores of quality of life,more social time and mental health,the whole body vibration training had the best effect on TUG and PCS.(3)T he effect of joint intervention on nutrition and exercise was unknown and should be treated cautiously.(4)Cognitive behavior intervention could reduce the incidence of falls among frailty elderly,and a preventive home visit program could decrease the depression of elderly people with poor activities of daily living.(5)Multifactorial interdisciplinary intervention and nutritional,physical,cognitive and combination interventions could reduce the incidence of frailty and the symptoms of frailty.3.Effect of frailty intervention in elderly with diseases Searching literatures with retrieval formul,5 literatures were included with 4 medium quality literatures and 1 low quality literatures.Research result was follows:(1)Seated exercise was one of the most effective intervention which had a better effect on frailty elderly with cardiovascular disease,which could improve the mobility and the psychological status,reduce the hospitalization rate and mortality.(2)Home-based pulmonary rehabilitation and Community comprehensive nursing could improve frailty status of elderly with COPD.Home-based pulmonary rehabilitation focused on breathing exercise and exercise training to improve physical function to reduce the incidence of frailty.Community comprehensive nursing could strengthen self-management and reduce hospitalization rate and mortality.(3)Comprehensive geriatric assessment management could decrease pain and negative emotions in frailty elderly with cancer.Conclusion 1.Different frailty assessment scale should be adopted due to different elderly people;FP is the most common frailty assessment tool for elderly,and SOF can be used for rapid screening for frail elderly,as well as FRAIL-NH is suitable for elders in long term care.2.The incidence of frail elderly patients in community,nursing institutions and hospitals was 11.4%,37.9% and 43.6% respectively with FP.Age,gender,marital status,educational level,drug use,income,comorbidity,and cognitive impairment were influencing factors of frailty in elderly.3.Exercise intervention,multifactorial interdisciplinary intervention and joint intervention(Nutrition + Exercise + cognitive intervention)could significantly improve the outcome of frail elderly,including physical and psychological aspects of frailty elderly and could be recommended for frailty elderly.Psychological adjustment could reduce the incidence of fall and decrease depression mood and could be recommended for frailty elderly with fear of falling and ADL dependent.4.Frailty elderly with different diseases should be adopted appropriate intervention.Seated exercise could be recommended for frail elderly people with cardiovascular disease,and community comprehensive nursing and home-based pulmonary rehabilitation could be recommended for frail elderly with COPD,and comprehensive geriatric assessment management could be recommended for frail elderly with cancer. |
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