Construction Of Evidence-based Management Program For Frail Elderly People In The Communit

Objectives:To conduct a systematic retrieval of the relevant guidelines on frailty management of the elderly,strictly evaluate the evidence,and form a summary of best practices recommendations,to refine recommendations,and to investigate the applicability of the recommendations in the domestic community,and ultimately to develop a "weak community elderly evidence-based management scheme",for old people to do a weak community "early evaluation and early prevention,early intervention",reduce the occurrence of adverse events in the elderly,improve their quality of life.Methods:① combination of semi-structured interview was used to understand community weak management status of the elderly,using Colaizzi seven steps to analyze data,extract the stakeholders(including community health care workers,and community)in the elderly of the cognitive and attitude toward weak management to weak,added the significance of this topic and evidence-based practice foundation;②the system to retrieve the authoritative guide at home and abroad,summarize the evidence site,both in English and Chinese journal database,and the elderly medical specialty society website decline in the elderly management related evidence-based guidelines or summary of evidence,retrieval time limit for a library(retrieval)the deadline of March 2019,the guidelines for assessment tool something Ⅱ,summarize the evidence evaluation tool CASE,each worksheet and JBI expert consensus evaluation tool for evidence of conformity with the inclusion criteria for quality evaluation;③extract,translate and integrate the recommendation opinions included in the evidence,refine the recommendation opinions through retrospective reference and supplementary retrieval,and hold expert discussions to select the best recommendation opinions suitable for the domestic community;④questionnaire combined with structured interview method to investigate the applicability of recommendations,clear the possible obstacles in the application;⑤formulate the action strategy according to the obstacles in the preliminary investigation,formulate the methodological guidance manual for the program application according to the contents of the i-PARIHS framework,make the supporting toolkit for program application,and finally construct and form the evidence-based management program for elderly people with debilitating diseases in the community.Results:①the elderly in the community have a wide range of cognition on senile frailty.The concept of senile frailty in the community is more accurate.hut there are not many contacts.but there are some cognitive misunderstandings.More than 70%of the elderly with frailty surveyed in the community wanted scientific frailty management,and community health care xvorkers agreed on the importance of any frailty management;②Finally,3 evidence-based guides,7 evidence summaries and 2 expert consensus were included.One of the evaluation guidelines was grade A.and the other two were grade B.The quality of evidence summary and expert consensus was reliable and all were included.③After extracting,translating,integrating and refining,a total of 21 recommendations were obtained.including 13 for practice,2 for education and training,and 6 for organizational policies.A total of 26 Suggestions were refined.After the expert demonstration.18 recommendations and 24 Suggestions were finally obtained.④of article 13 recommendations,there are 7 respondents considered can be carried out by all,operable,article 6 by at least one person up to five other people think is "do not carry out/do not operate".was selected with the highest frequency of 5 inhibitors were not enough time and manpower,the elderly demand insufficient motivation.there is no corresponding rules and regulations,lack of knowledge and skills and the elderly the body factors;⑤the evidence-based management plan for the elderly in the community includes educational and training materials(knowledge manual for the staff of the management of elderly in the community,publicity leaflets for the popularization of knowledge of elderly in the community,and publicity videos for the popularization of knowledge of elderly in the community)implementation manuals and toolkits.Conclusion:community weak old people management work to reduce the occurrence of adverse events in the elderly,improve the quality of life of the significance.the research of the weak community elderly evidence-based management plan includes screening.assessment of the weak,physical fitness,nutrition intervention,medication and other aspects.rich in content good maneuverability and can be used to guide the practice of community weak old people management.but the recommendations must be combined with the actual application scenario for the can play a maximum effect,thus practitioners should focus on to promote or hinder factors of evaluation,contents of flexible implementation plan.