痴呆患者睡眠障碍管理的最佳证据总结

·528·护士进修杂志2023年3月第38卷第6期·循证护理研究·痴呆患者睡眠障碍管理的最佳证据总结孙海燕1周婷婷2唐雪婷2张蕊2袁长蓉2(1.江苏医药职业学院，江苏盐城224005：2.复旦大学护理学院，上海200032)摘要目的总结痴呆患者睡眠障碍管理相关证据，以其为医护人员和相关利益者提供参考。方法根据证据金字塔式方法，对国内外数据库中痴呆患者睡眠障碍管理相关文献进行系统性检索，包括临床决策、指南、专家共识，证据总结及系统评价，检索时间为2016年1月1日一2021年12月31日，对纳入文献质量进行评价并提取证据，结果共纳入文献21篇，包括指南8篇、专家共识4篇、系统评价9篇，从睡眠障碍评估、非药物干预、药物治疗以及健康教有4个方面总结出21条证据，结论痴呆患者睡眠障碍管理证据可为医护人员开展睡眠管理提供循证依据，最佳证据的应用，需结合医护人员的专业判断，综合考虑患者的需求和偏好，应用证据的具体情境，分析证据与实践的差距，以便制订符合我国临床实践的痴呆患者个性化睡眠障碍管理方案，关键词痴呆：认知障碍：睡眠管理：睡眠障碍：证据总结：循证护理Summary of the best evidence for the management of sleep disorder in patients with dementiaSUN Haiyan',ZHOU Tingting?,TANG Xueting?,ZHANG Rui,YUAN Changrong?1.Jiangsu Vocational College of Medicine,Yancheng 224005,Jiangsu,China:2.School of Nursing,Fudan University,Shanghai 200032,China)Abstract Objective To summarize the evidence related to the management of sleep disorder in people with de-mentia so as to provide a reference for health care workers and relevant stakeholders.Methods According to thepyramid model of evidence,all the literature related to management of sleep disorder in people with dementia fromdomestic and foreign databases was searched from January 2016 to December 2021,including relevant clinical deci-sions,guidelines,expert consensuses,evidence summaries,and systematic reviews.The quality of the included lit-eratures was evaluated and then the evidence was extracted.Results A total of 21 articles were included,including 8guidelines,4 expert consensus,and 9 systemic reviews.A total of 21 pieces of best evidence from were summarizedfrom 4 aspects,covering assessment of sleep disorder,nompharmacological intervention,pharmacotherapy,andhealth education.Conclusion The evidence of sleep disorder management in patients with dementia can provide effec-tive evidence-based information for the clinical use of medical staff.The application of the best evidence should becombined with the professional judgment of the medical staff,comprehensive consideration of patients'needs andpreferences,the specific situation of applied evidence,and analyze the gap between evidence and practice,so as toconstruct an personalized management plan for sleep disorder in dementia patients in line with clinical practice in China.Keywords dementia:cognitive impairment:sleepmanagement:sleep disorder:evidence summary;evidence-based nursing中图分类号：R473.74文献标识码：AD01:10.16821/1.cmki.hjx.2023.06.010痴呆是以认知功能损害、精神行为改变及工作生数约900多万例，居世界痴呆患病人数第1位。睡活能力下降为主要临床表现的一组慢性进行性精神眠障碍是痴呆患者常见的精神行为症状，包括难以入衰退性疾病，多发生于65岁以上的老年人群)。老睡及维持睡眠、睡眠片段化、夜行及日间过度嗜睡等，龄化加速了我国痴呆的患病率，2019年我国患病人研究)报道，超过60%的痴呆患者会出现睡眠行为基金项目：江苏省职业教有教师教学创新团队建设项口（编号：苏教办师函[2021]23号）：江苏省高职院校教师专业带头人高端研修项日（编号：2020GRFX044):江苏省高等职业教有高水平专业群建设项日（编号：苏教职函[2021]1号）作者简介：孙海燕(1983一)，女，江苏滨海，博士在读，副教授，研究方向：老年护理，慢病管理通信作者：袁长蓉，E-mail:yuancr(@fudan.edu.cn(C)1994-2023 China Academic Journal Electronic Publishing House.All rights reserved.http://www.cnki.net