基于Delphi法ICU患者误吸风险评估体系的构建  

Development of Indicator System of Aspiration Risk Evaluation in ICU with Delphi Method

作　　者：吴巧媚 张利娟[1,2] 郑静霞 

机构地区：[1]广州中医药大学第二附属医院,广东广州510120 [2]广东省中医院,广东广州510120

出　　处：《护理学报》2018年第2期1-6,共6页Journal of Nursing（China）

基　　金：广东省科技厅科技计划项目(2016KT1171)

摘　　要：目的构建科学、系统、可行的ICU患者误吸风险评估体系。方法在文献调研和小组讨论的基础上,运用Delphi法对20名相关领域专家进行2轮咨询,确定评价指标体系。结果 2轮函询中,问卷回收率分别为91%和100%,权威系数分别为0.887、0.893,最终构建了包含4项一级指标和20项二级指标的ICU患者误吸风险评估体系。最终确定的一级指标重要性评分均数为4.25~4.95,满分比为0.90~1.00,变异系数为0.05~0.15,二级指标重要性评分均数为3.85~5.00,满分比为0.70~1.00,变异系数为0.03~0.18,Kendall’s W为0.285(P<0.001);二级指标下等级条目风险性附分值的合适性评分均数为4.05~4.90,满分比为0.80~0.95,变异系数为0.10~0.17,Kendall’s W为0.161(P<0.001)。结论本研究构建了包括自身因素、进食管理、气道管理及药物使用情况4大类一级指标和20项二级指标的误吸风险评估体系。本研究构建的误吸风险评估体系具有较高的科学性和可靠性,可为ICU患者的误吸风险评估工作提供参考依据,也可为下一步的量表开发奠定基础。Objective To develop a scientific and feasible indicator system to evaluate aspiration risk in ICU. Methods The indicator system was developed after literature review, group discussion and two-round expert consultations conducted among 20 experts in related fields. Results In two rounds of surveys, response rates of the questionnaire were 91% and 100% respectively and the authoritative coefficients were 0.887 and 0.893 respectively. The indicator system consisted of 4 first-level and 20 second-level indictors. The mean value of importance scoring of first-level indicators ranged from 4.25 to 4.95; the full score ratio from 0.90 to1.00, variation coefficient from 0.05 to 0.15. While, the mean value of importance scoring of second-level indicators ranged from3.85 to 5.00; the full score ratio from 0.70 to 1.00; variation coefficient from 0.03 to 0.18 and Kendall ＇s W was 0.285（P〈0.001）. The fitness scores of risk appendages of grade items under the two-level index ranged from 4.05 to 4.90, the full score ratio from 0.80 to 0.95,variation coefficient from 0.10 to 0.17, and Kendall ＇s W was 0.161（P〈0.001）. Conclusion The developed indicator system for aspiration risk evaluation in ICU, consisting of 4 first-level indictors and 20 second-level indictors, which cover personal factors,dietary management, airway management and medication usage, is reliable and valid and it provides the basis for the development of further scales or instruments.

关 键 词：重症监护病房 误吸 DELPHI法 风险评估 指标体系 

分 类 号：R473[医药卫生—护理学]