The Effect Of Evidence-based Early Activities On The Cognitive Function Of Severely Ill Patients

Background:The incidence of cognitive dysfunction in ICU is high,which seriously affects patients,families and society.At present,studies have shown that early mobilization is safe and feasible in ICU,and that can be used as an intervention to improve cognitive function,but no studies have verified its effect.One of the main reasons for the low rate of early mobilization is lack of scientific mobilization.Therefore,it is necessary to use evidence-based methods to construct an early mobilization program and to verify its effect on cognitive function in ICU.Objective:To construct an early mobilization program for intensive care unit and to verify its effect on cognitive function.Methods:This study was divided into two parts.Part one:based on a large number of literature,this study builds a preliminary mobilization draft of ICU patients through evidence synthesis,and then screens each item index through expert consultation to determine the early mobilization plan of ICU patients.Part two:This study is an experimental study,which facilitates the extraction of 60 mechanical ventilation time24h in a third-grade hospital in Beijing,it is expected that patients with severe ICU stay time?72h will be required.From August 2018 to November 2018 patients were included as a control group,and patients were included as intervention groups from November 2018 to February 2019.The patients in the control group were routinely placed in a wheelchair,2 times a day,1-2 hours each time.The intervention group implemented the early mobilization according to the program with existing conditions.Patients were measured cognitive function with ACE discharged from the hospital.Results:Part one:This study included 9 randomized controlled trials,6 systematic literature evaluations and meta-analysis,2 expert consensus,10 of which were rated IA,5 were rated IIB,and 2 were rated IVB.The enthusiasm of the experts in the two rounds of letters was 87.5%and 100%respectively,and the expert authority coefficient was 0.911.Part two:30 patients were included in the control group and 30 in the intervention group.After comparison,There was difference in memory between the two groups(P=0.042),the incidence of cognitive dysfunction and the other dimensions of cognitive function were not statistically significant(P>0.05).Conclusion:This study builds an early mobilization program for patients in intensive care unit based on evidence synthesis and expert correspondence.Early mobilization can improve the memory of ICU patients,and fail to effectively improve the incidence of cognitive dysfunction and the remaining dimensions of cognitive function.However,the cognitive function of this population has improved,and further research is needed in the future.