婴儿安全睡眠保护策略的证据总结

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目的:系统评价国内外婴儿安全睡眠保护策略的相关证据,并对证据进行总结,为临床循证决策及指南的制定提供参考。方法:以“婴儿/新生儿”“死亡/婴儿猝死综合征”“睡眠保护策略/安全睡眠/睡眠”和“Infant Death/Sudden Unexpected Infant Death/Sudden Infant Death Syndrome”“Sleep protecting program/Sleep safety/Sleeping environment”为关键词,系统检索美国国立指南网、加拿大安大略省注册护士协会、英国国家卫生与照护优化研究所、苏格兰校际间指南网、国际指南协作网、UptoDate、Embase、中国知网、万方等数据库截至2020年3月发表的关于婴儿睡眠安全保护策略的文献。纳入标准为以0~1岁的婴儿为研究对象,以婴儿安全睡眠保护策略或护理为主题的指南、证据总结及系统综述,并可获取全文。排除标准包括重复收录、直接翻译的文献及指南的摘要、讨论稿、指南草案、解读、节选等。采用欧洲指南研究与评估工具(AGREE Ⅱ)和系统评价方法学质量评价工具(AMSTAR Ⅱ)对筛选的文献进行比较和评价,并对符合质量标准的文献进行证据提取。结果:共纳入12篇文献,包括来自UptoDate的证据总结1篇,指南3篇,系统综述8篇。AGREE Ⅱ质量评价结果显示,3篇指南整体质量较好,其中推荐等级为“A”的有1篇,等级为“B”的有2篇;AMSTAR Ⅱ质量评价显示,系统综述的质量除1篇文献外,内容均较为完善。最终形成证据总结39条,包括评估、计划、实施、健康教育(孕产妇、父母及其他婴儿照护者)、评价及组织与政策6个方面。结论:婴儿安全睡眠保护的证据总结,为制定婴儿安全睡眠护理规范,开展科学、高质量的临床护理实践提供了证据支撑。“,”Objective:To systematically review and summarize the relevant evidence of safe sleep protection strategies for infants at home and abroad, to provide a reference for clinical evidence-based decision-making and guideline formulation.Methods:“Infant Death/Sudden Unexpected Infant Death/Sudden Infant Death Syndrome” and “Sleep protecting program/Sleep safety/Sleeping environment” were used as search keywords. The literature retrieval for all the Chinese and English evidence on safe sleep protection strategies for infants published before March 2020 was conducted by using the National Guideline Clearinghouse (NGC), Registered Nurse′ Association of Ontario (RNAO), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), JBI, Clinical Evidence, China Evidence-based Medicine Center, PubMed, Embase, CINAHL, Wanfang Data, CNKI and other databases. Inclusion criteria were guidelines, evidence summary and systematic reviews on infant safe sleep protection strategies for infants aged 0 to 1 years. The full text was available. Exclusion criteria include duplicates, directly translated documents as well as guide abstracts, discussion drafts, draft guides, interpretations, excerpts. The Appraisal of Guideline for research & Evaluation Instrument (AGREE Ⅱ) and A Measure Tool to Assess Systematic Reviews (AMSTAR 2) were used to compare and evaluate the selected literature, and extracted evidence from the literature that meets the quality standards.Results:A total of 12 articles were incorporated into study, including 1 Summary of evidence from UptoDate, 3 guidelines, and 8 systematic reviews. The results of the AGREE II quality evaluation showed that the overall quality of 3 guidelines was high. Among them, there was 1 with a recommendation level of “A”, and 2 with a rating of “B”. The AMSTAR 2 quality evaluation showed that the contents of the systematic reviews were relatively complete except for one literature. In the end, totally 39 terms of evidences were summarized, including 6 aspects of assessment, planning, implementation, health education (pregnant women, parents and other infant caregivers), evaluation, organization and policy.Conclusion:The evidence summary of infant safe sleep protection provides evidence support for formulating infant safe sleep care standards and carrying out scientific and high-quality clinical nursing practices.
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