Summary Of The Best Evidence For The Application Of Scraping In Patients With Neck, Shoulder And Low Back Pain And Research On Factors Affecting Clinical Implementatio

Objectives:The aim of this study is to search,evaluate,and summarize the relevant evidence of the application of scraping in patients with neck,shoulder,and low back pain,form the best evidence summary,and develop evidence-based practice review indicators to analyze the obstacles and promoting factors that affect clinical implementation.Methods:1.Based on the PIPOST model,an evidence-based problem retrieval database was established to search for relevant literature on the application of scraping in patients with neck,shoulder,and low back pain from March 2012 to April 2022.The quality of the included literature was evaluated and the evidence from the high-quality literature was summarized.2.Through the expert meeting method and based on the FAME strategy,complete the applicability evaluation of relevant evidence in four aspects: feasibility,suitability,clinical significance,and effectiveness,screen suitable evidence items for inclusion in clinical practice,and develop review indicators.3.Through the current situation survey method,based on review indicators,baseline review of the clinical practice status of the department was conducted using observation methods,questionnaire surveys,and other methods.Based on the review results,obstacles and promoting factors affecting clinical implementation were analyzed.Results:1.Finally,one guideline,two systematic evaluations,and six randomized controlled trial studies were included,and the overall quality of the literature was relatively high;Extracting,categorizing,and summarizing the evidence in the literature has resulted in 21 pieces of evidence for the application of scraping in patients with neck,shoulder,and low back pain,including 6 aspects: preparation before scraping,scraping intervention methods,scraping degree,precautions,contraindications,and abnormal situation handling.2.Through the expert meeting method,the applicability evaluation of relevant evidence was completed,and 1 inappropriate evidence item was deleted.The 12 evidence items intended for inclusion in clinical practice were adjusted and integrated,resulting in a summary of the best evidence for the application of scraping in patients with neck,shoulder,and back pain.Based on the 20 evidence items,10 review indicators were developed,including 4 at the department level,5 at the nurse level,and 1 at the patient level.3.Based on 10 review indicators,analyze the obstacles and promoting factors in the application of evidence by nurses in 4 departments.The baseline review results showed that out of the 10 review indicators,4 had an implementation rate of<60%,and3 had an implementation rate of 0.This includes a lack of relevant risk system assessment tools at the department level and a lack of evidence-based standardized operational processes.The survey questionnaire on the evidence-based nursing practice level of clinical nursing staff in the department shows that obstacle factors include: the main source of nurse knowledge is based on "years of nursing work experience","insufficient time to search for research reports","insufficient time to implement new nursing methods in work","lack of nurse knowledge",etc;The promoting factors include: "Nursing leaders support me in changing my original nursing practice methods." The results show a positive attitude towards clinical evidence-based change,fully realizing the importance of evidence-based practice,and playing a positive role in the conversion of best evidence in clinical implementation.Conclusion:1.Although there have been few guidelines for the application of scraping in patients with neck,shoulder,and back pain in the past 5 years,the quality of literature on related systematic evaluations and randomized controlled trials has been relatively high in recent years.This study constructed the best evidence summary for the application of scraping in patients with neck,shoulder,and back pain,and evaluated the applicability of the relevant evidence through expert meetings.Finally,20 best evidence summary items were formed,including preparation before scraping,scraping intervention methods,scraping degree The best evidence summary for promoting the application of scraping in patients with neck,shoulder,and low back pain is summarized from six aspects: precautions,contraindications,and abnormal situation handling.It is scientifically and operationally applicable in clinical practice,providing high-quality intervention directions and strategies for evidence-based clinical scraping practice.2.A scientific and comprehensive evaluation of the best evidence affecting the application of scraping in patients with neck,shoulder,and back pain summarizes the obstacles and promoting factors in clinical implementation,which can improve nurses’ practical ability,promote evidence-based practice interest,obtain satisfaction from evidence-based practice,promote the application of the best evidence of scraping in neck,shoulder,and back pain patients in clinical practice,improve the operational level of medical staff,and provide reference for improving nursing outcomes.