目的 构建《儿童难治性癫痫生酮饮食治疗患者指南》.方法 本指南基于A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT)理论框架和以患者为导向知识工具,形成研究路线.通过明确研究问题、证据整合、指南形成等规范步骤,构建《儿童难治性癫痫生酮饮食治疗患者指南》.结果 共形成17条儿童难治性癫痫生酮饮食治疗相关的研究问题;共纳入11篇文献,包括指南4篇、共识7篇;最终构建的患者指南包含评估,实施前准备,实施与监测,随访、评价与终止4个主题、29条推荐条目.结论 本研究构建的患者指南,基于科学的构建框架与方法,充分考虑患者需求,可为管理难治性癫痫患儿的生酮饮食治疗提供参考.
Objective:To evaluate the quality and reporting standards of the ketogenic diet guidelines and consensuses in children with refractory epilepsy at home and abroad.Methods:A systematic search was conducted using the English and Chinese keywords for screening relevant guidelines and expert consensus on the Guidelines International Network, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence, the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care in Australia, DynaMed Evidence-Based Medicine Database, American Academy of Neurology, American Epilepsy Society, International League Against Epilepsy, Child Neurology Society, European Paediatric Neurology Society, International Ketogenic Diet Research Group, Cochrane Library, PubMed, CNKI, Wanfang Database, VIP, China Biology Medicine disc, etc. The search period was from establishment of databases to August 13, 2021. The quality of the guidelines was evaluated using the The Appraisal of Guidelines for Research and EvaluationⅡ, and the Reporting Items for Practice Guidelines in healthcare was used to evaluate the reporting standards of guidelines. The JBI Center for Evidence-based Health Care Quality Evaluation tool was used to evaluate the quality of expert consensuses, and the National Institutes of Health Reporting Standards was used to evaluate the reporting standards of expert consensuses.Results:A total of 1 864 literatures were searched initially. According to the inclusion and exclusion criteria and reading the literature content, 13 literatures were selected, and after manual search, 1 literature was supplemented. Finally, a total of 14 literatures were obtained, including 7 guidelines and 7 expert consensuses. The quality evaluation results showed that 2 guidelines were grade A, 2 guidelines were grade B and 3 guidelines were grade C. 5 expert consensuses were rated "Yes" in the six items of quality evaluation. The results of the evaluation of reporting norms showed that the seven expert consensus reports were of poor quality; the higher the methodological quality rating of the guidelines, the better their reporting quality.Conclusions:The overall quality of the 14 guidelines and expert consensuses included is high, and attention should be paid to research quality in terms of application and participants. The reporting standards need to be further improved, and in the future, researchers can pay more attention to the reporting standards in the process of formulating guidelines and expert consensus, achieving a more rigorous research process and better applying evidence to clinical practice.
With the gradual rise of the shared-decision making model, the means to promote the joint participation of patients and doctors in medical decision-making are also increasing and developing. Patient decision aids (PDAs) are one of the most representative interventions. The main features include targeting patients, content based on the best evidence, easy-to-understand language, diverse presentation styles and overall clear and concise content. Research on PDAs is increasing year by year. In order to make it more scientific, normative and applicable, research institutions in Canada, the United States and the United Kingdom have all explored their construction methods and evaluation standards and have successively released international standards, reporting standards and standard framework for PDAs, etc. This paper introduces the conceptual connotation, construction method and presentation standards of PDAs, in order to provide reference and reference for PDAs researchers in China.
Obesity is one of the metabolic diseases that affect psychosomatic health of people and is a risk factor of many chronic diseases. In recent years, the incidence of obesity continues to rise, thus effective weight control and healthy weight loss have become the focus and difficulty of medical research today. Studies have shown that internal microecological changes are related to the occurrence of obesity. Comprehensive health education and nursing play an important role in weight management by adjusting intestinal microecological environment. This paper comprehensively describes the effect of intestinal microecological environment on obesity. The intestinal microecology induces obesity by regulating the nervous system, participating in energy metabolism, regulating immunity and other mechanisms. Interventions such as diet, emotion, exercise and traditional Chinese medicine nursing techniques can regulate the intestinal microecological environment and effectively manage body weight.