老年结肠镜检查患者肠道准备关键点指导方案的构建研究  

Construction of key-point guidelines of bowel preparation for elderly patients undergoing colonoscopy

作　　者：张媛媛[1,2] 钮美娥[3] 汪茜雅[1] 吴振云[2] 顾洁[1] Zhang Yuanyuan;Niu Meie;Wang Qianya;Wu Zhenyun;Gu Jie(Department of Gastroenterology,the First Affiliated Hospital,Soochow University,Suzhou,215006,China;School of Nursing,Soochow University,Suzhou,215006,China;Department of Nursing,the First Affiliated Hospital,Soochow University,Suzhou,215006,China)

机构地区：[1]苏州大学附属第一医院消化内科,江苏苏州215006 [2]苏州大学护理学院,江苏苏州215006 [3]苏州大学附属第一医院护理部,江苏苏州215006

出　　处：《现代临床护理》2018年第1期10-16,共7页Modern Clinical Nursing

基　　金：苏州市科技计划基金项目;项目编号为SYS201615

摘　　要：目的探讨构建老年结肠镜检查患者的肠道准备关键点指导方案。方法以理论分析、文献回顾、质性访谈为基础,选择全国7个省市临床护理、护理教育、医疗专家3个领域的14名专家采用德尔菲法(Delphi)对该方案进行2轮专家咨询,最终确立老年结肠镜检查患者肠道准备关键点指导方案表。结果两轮专家函询表有效回收率均为100.00%;两轮专家的权威程度系数均为0.89;第一轮与第二轮各条目的变异系数分别为0.07~0.27与0.05~0.13;Kendall's协调系数分别为0.377和0.404(χ2值分别为105.473和124.307,均P<0.001);第一轮函询各条目的重要性均数为3.50~4.95,标准差为0.35~0.95,第二轮函询各条目的重要性均数为4.71~4.93,标准差为0.27~0.61。老年结肠镜检查患者肠道准备关键点指导方案包括3个肠道准备关键点,4个关键指导时机,7项关键指导内容,4项肠道准备判断标准及4项对应的补救措施。结论本研究构建了老年结肠镜检查患者肠道准备关键点指导方案,经统计分析咨询结果可靠,专家的积极程度、权威程度、协调程度及集中程度均较高,能为临床开展规范化的肠道准备指导工作提供参考。Objective To construct the key-point guidelines of bowel preparation for elderly patients with colonoscopy.Methods The guidelines were made based on literature review,theoretical analysis,qualitative interview.Then they were determined by14clinical nurse specialists,nursing education experts and medical experts from6provinces or cities through two rounds of expert consultations.Results The response rate of two rounds'questionnaire was100.00%.The authority of experts coefficient in the two rounds were0.89.The coefficients of variation of the first and second rounds were respectively0.07~0.27and0.05~0.13.The coordination coefficients for the2rounds were0.377and0.404respectively(X2=105.473and124.307,P<0.001).In the first round,the average of the importance rating was3.50~4.95,with a standard deviation of0.35~0.95.In the second round,the average of the importance rating was4.71~4.93,with a standard deviation of0.27~0.61.The key-point guidelines of bowel preparation included3key points for bowel preparation,4key moments,7key guidance contents,4criteria for the process of bowel preparation and the corresponding remedial measures.Conclusion This study established the key-point guidelines of bowel preparation for elderly patientsand the degree of enthusiasm,authority,coordination and concentration of the experts was high so as to provide a reference for the clinical implementation of standardized bowel preparation guidance.

关 键 词：老年患者 结肠镜 肠道准备 关键点控制原理 

分 类 号：R47[医药卫生—护理学]