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1.文献信息：
Title:Nutritional assessment in acute stroke patients: A systematic review of guidelines and systematic reviews.
急性脑卒中患者的营养评估：指南和系统综述的再评价。
Journal:International Journal of Nursing Studies .
IF//JCR分区: 7.5/Q1.
Keyword:Dysphagia ; Malnutrition ; Nutritional assessment ; Stroke.
吞咽困难；营养不良；营养评估；中风。
Design:Systematic review of clinical practice guidelines and systematic reviews.
临床实践指南和系统评价的再评价。
2. 摘要 Abstract：
（译文仅供参考）
Introduction: Dysphagia and malnutrition are major contributors to mortality in patients with acute stroke. An early assessment of nutritional status upon hospital admission is crucial to enhance clinical outcomes by reducing the associated high-risk complications. However, the fragmented nature of the existing literature makes it difficult to optimize clinical practices.
背景：吞咽困难和营养不良是急性脑卒中患者死亡的主要原因。入院时早期评估营养状况对于通过减少相关的高危并发症来提高临床结果至关重要。然而，现有文献的碎片化性质使得优化临床实践变得困难。
Objective: This study aims to identify the best clinical practices that nurses and other healthcare professionals can employ for the immediate assessment of nutritional risk in patients diagnosed with acute stroke.
目的：本研究旨在确定护士和其他医疗保健专业人员可用于急性中风患者营养风险即时评估的最佳临床实践。
Data sources: Comprehensive bibliographic searches were conducted up to May 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across the databases Cochrane Library, PubMed, Embase, CINAHL, and Scopus, and three recognized guideline repositories.
数据来源：根据系统评价和荟萃分析（PRISMA）指南，在Cochrane Library、PubMed、Embase、CINAHL和Scopus以及三个公认的指南存储库中进行了截至2024年5月的综合书目检索。
Review methods: The quality of clinical practice guidelines was ascertained using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and the quality of systematic reviews was assessed through A MeaSurement Tool to Assess Systematic Reviews (AMSTAR 2). The evidence quality was appraised based on the classifications by the European Society of Cardiology.
评价方法：采用研究与评价指南评估II （AGREE II）工具确定临床实践指南的质量，通过评估系统评价的测量工具（AMSTAR 2）评估系统评价的质量。依据欧洲心脏病学会的分类对证据质量进行评价。
Results: Out of 2534 identified records, 15 were incorporated into this review. Predominantly, the selected clinical practice guidelines and systematic reviews exhibited high methodological quality. Notably, the Gugging Swallowing Screen and the Malnutrition Universal Screening Tool were pinpointed as primary tools for initial screenings. Most studies recommended that these assessments, ideally conducted within the first 24 h of patient admission, should be carried out by specially trained professionals, highlighting the pivotal role of nurses. Deviations in screening outcomes necessitate complementary specialist evaluations.
结果：在2534份确定的记录中，有15份纳入了本综述。主要是，选定的临床实践指南和系统评价显示出较高的方法学质量。值得注意的是，gugging吞咽筛查和营养不良普遍筛查工具被确定为初始筛查的主要工具。大多数研究建议，这些评估最好在患者入院后24小时内进行，应由受过专门培训的专业人员进行，强调护士的关键作用。筛查结果的偏差需要补充的专家评估。
Conclusions: This systematic review offers a consolidation of current insights, proposing an innovative and integrated approach to assess nutritional needs of high-risk patients. It underscores the importance of nurses in the screening process, emphasizing their pivotal role in the nutritional management of patients with acute stroke, and advocates for further research endeavors to standardize intervention protocols to elevate patient clinical outcomes.
结论：本系统综述巩固了当前的见解，提出了一种评估高危患者营养需求的创新和综合方法。它强调了护士在筛查过程中的重要性，强调了他们在急性中风患者营养管理中的关键作用，并倡导进一步的研究努力来标准化干预方案，以提高患者的临床结果。
3.文献新知扩展：
①The PICOR framework是什么
原文原句：The PICOR research question, a significant advancement in the context of CPGs and SRs, integrates the ‘A’ component from the PICAR (Johnston et al, 2019) and the PICO T/S framework (Pollock and Berge, 2018; Methley et al, 2014). Specifically, the PICOR approach provides a methodological structure tailored to the unique features of CPGs and SRs, with a pronounced focus on the ‘R’ (Recommendations) component.
PICOR研究问题是cpg和SRs背景下的一个重大进步，它整合了PICAR 和PICO T/S框架。具体来说，PICOR方法提供了一种针对cpg和SRs的独特特征量身定制的方法结构，其重点是“R”（建议）部分。
②GUSS吞咽障碍测试问卷是什么
GUSS吞咽障碍测试问卷，全称为Gugging Swallowing Screen (GUSS)，是一种用于评估吞咽功能的工具。它通过一系列的问题和测试来评估患者的吞咽能力，包括对不同稠度食物的吞咽情况。GUSS测试通常用于临床环境中，以帮助医生和治疗师识别吞咽障碍，并制定相应的治疗计划。
GUSS吞咽障碍测试问卷通常包括以下几个部分：
④GPGs是什么
原文原句：To date, various government agencies and scientific societies have invested considerable resources in producing clinical practice guidelines (GPGs)
迄今为止，各种政府机构和科学学会已经投入了大量资源来制定临床实践指南（gpg）。
Clinical Practice Guidelines (GPGs)，即临床实践指南，是基于系统评价的证据和平衡了不同干预措施的利弊，在此基础上形成的能为患者提供最佳保健服务的推荐意见。这些指南通常由专业组织或机构制定，旨在帮助临床医生和其他卫生保健提供者在面对特定的临床问题时做出决策。
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