摘要目的 评价老年功能性便秘管理相关指南的质量,为临床决策及构建符合我国本土的老年功能性便秘循证指南提供参考意见.方法 计算机检索国际指南协作网(GIN)、美国国立指南库(NGC)、英国国家医疗保健优化研究所(NICE)、苏格兰校际指南网络(SIGN)、加拿大医学协会临床实践指南(CMA)、新西兰指南协作组(NZGG)、加拿大安大略省注册护士协会(RNAO)、澳大利亚医学临床实践指南库(NHMRC)、美国胃肠病学学会(ACG)、中国临床指南文库(CGC)、医脉通指南网以及中英文电子数据库,根据纳入、排除标准筛选公开发表的有关老年功能性便秘管理的循证指南.采用临床指南研究与评估系统(AGREE Ⅱ)对检索到的相关指南进行方法学质量评价,使用组内相关系数进行评价者间一致性检验,并进行各指南推荐意见的分析.结果 共纳入5部循证指南,均来自国外;5部指南在6个领域的 AGREE Ⅱ评价平均得分:范围和目的97.78%,参与人员78.52%,严谨性79.86%,清晰性89.63%,应用性63.89%和独立性86.67%;5部指南的组内相关系数0.887~0.971;指南总体质量评价为3个A级, 2个B级;指南各护理推荐内容基本一致.结论 纳入的指南总体质量较高,我国目前尚无本土化老年功能性便秘管理指南,高质量的指南可以为我国老年功能性便秘护理的临床实践指南的制定提供证据支持,但是将国外指南应用于我国临床环境之前必须经过严格的本土化过程.

abstractsObjective To evaluate the quality of evidence-based guidelines on senile functional constipation management and provide references for decision-making and the development of evidence-based guidelines suitable for China. Methods A search of Guideline International Network (GIN), National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Canadian Medical Association (CMA), New Zealand Guidelines Group (NZGG), Registered Nurses Association of Ontario (RNAO), National Health and Medical Research Council (NHMRC), American College of Gastroenterology (ACG), China Guideline Clearinghouse (CGC), Medlive website, and related websites and databases were conducted to screen the guidelines on senile functional constipation management with inclusion and exclusion criteria. Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) was applied on the methodological value evaluation for searched guidelines. The overall agreement among 3 appraisers was measured by the intraclass correlation coefficient (ICC). The analysis of advices from guidelines was performed. Results A total of 5 evidence-based guidelines were included, which were all from abroad. The average scores of guidelines in six domains of AGREE Ⅱ were 97.78% (scope and purpose), 78.52% (stakeholder involvement), 79.86% (rigor of development), 89.63% (clarity of presentations), 63.89% (applicability), and 86.87% (independence) respectively. The ICC were 0.887- 0.971. Considering the overall quality evaluation, 3 of them were grade A and 2 of them were grade B. The recommendations of included guidelines were almost consistent. Conclusions The overall quality of included guidelines is high. There is no local evidence-based guideline of senile functional constipation management in China. High-quality guidelines can offer the evidence support for the development of clinical practical guideline for senile functional constipation management. Foreign guidelines should be localized before their application in the clinic in China.