Buma Lise E, Vluggen Stan, Zwakhalen Sandra, Kempen Gertrudis I J M, Metzelthin Silke F
Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
Eur J Ageing. 2022 May 3;19(4):903-929. doi: 10.1007/s10433-022-00693-3. eCollection 2022 Dec.
This systematic review aimed to provide an overview of reablement interventions according to the recently published ReAble definition and their effect on Activities of Daily Living (ADL). In addition, the most common and promising features of these reablement interventions were identified. Four electronic bibliographic databases were searched. Articles were included when published between 2002 and 2020, which described a Randomised or Clinical Controlled Trial of a reablement intervention matching the criteria of the ReAble definition, and had ADL functioning as an outcome. Snowball sampling and expert completion were used to detect additional publications. Two researchers screened and extracted the identified articles and assessed methodological quality; discrepancies were resolved by discussion and arbitration by a third researcher. Twenty relevant studies from eight countries were included. Ten of these studies were effective in improving ADL functioning. Identifying promising features was challenging as an equal amount of effective and non-effective interventions were included, content descriptions were often lacking, and study quality was moderate to low. However, there are indications that the use of more diverse interdisciplinary teams, a standardised assessment and goal-setting method and four or more intervention components (i.e. ADL-training, physical and/or functional exercise, education, management of functional disorders) can improve daily functioning. No conclusions could be drawn concerning the effectiveness on ADL functioning. The common elements identified can provide guidance when developing reablement programmes. Intervention protocols and process evaluations should be published more often using reporting guidelines. Collecting additional data from reablement experts could help to unpack the black box of reablement.
The online version contains supplementary material available at 10.1007/s10433-022-00693-3.
本系统评价旨在根据最近发布的“恢复能力”定义,概述恢复能力干预措施及其对日常生活活动(ADL)的影响。此外,还确定了这些恢复能力干预措施最常见和最有前景的特征。检索了四个电子文献数据库。纳入2002年至2020年期间发表的文章,这些文章描述了符合“恢复能力”定义标准的恢复能力干预措施的随机或临床对照试验,并将ADL功能作为一项结果。采用滚雪球抽样和专家补充法来发现其他出版物。两名研究人员筛选并提取了已识别的文章,并评估了方法学质量;分歧通过第三名研究人员的讨论和仲裁得以解决。纳入了来自八个国家的20项相关研究。其中10项研究在改善ADL功能方面有效。由于纳入了数量相等的有效和无效干预措施、内容描述往往缺乏且研究质量为中等至低等,因此确定有前景的特征具有挑战性。然而,有迹象表明,使用更多样化的跨学科团队、标准化评估和目标设定方法以及四个或更多干预组成部分(即ADL训练、身体和/或功能锻炼、教育、功能障碍管理)可以改善日常功能。关于对ADL功能的有效性无法得出结论。所确定的共同要素可为制定恢复能力计划提供指导。应更频繁地使用报告指南来发表干预方案和过程评估。从恢复能力专家那里收集更多数据有助于揭开恢复能力的“黑匣子”。
在线版本包含可在10.1007/s10433-022-00693-3获取的补充材料。