基于循证和德尔菲法构建ICU患者睡眠管理方案  

Development of a sleep management protocol for ICU patients based on evidence-based medicine and Delphi technique

作　　者：周丹 杨青敏[1,2] 顾艳荭 龚晨[1,2] 王光鹏 乔建歌 Zhou Dan;Yang Qingmin;Gu Yanhong;Gong Chen;Wang Guangpeng;Qiao Jiange(School of Nursing,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属上海市第五人民医院重症监护室

出　　处：《护理学杂志》2019年第12期54-57,共4页Journal of Nursing Science

基　　金：上海市闵行区自然科学研究课题(2018MHZ076);复旦大学附属上海市第五人民医院曙光人才培养计划(2017WYRCSG06)

摘　　要：目的提高ICU患者的睡眠质量。方法采用循证方法筛选最佳证据,经研究小组讨论构建ICU睡眠管理初步方案;采用德尔菲法向20名危重症领域医疗护理专家进行2轮函询。结果纳入12项高质量证据,构建包括失眠诊断、睡眠质量评估、睡眠危险因素评估、睡眠危险因素干预、其他提高睡眠质量措施的5个方面共11项内容的睡眠管理方案;专家积极性为100%,权威系数0.84,变异系数0.17~0.21,W值0.196、0.249,均P<0.01。结论本ICU患者睡眠管理方案构建过程严谨,结果可靠,可用于临床ICU患者的睡眠管理,以验证该管理方案的适用性。Objective To enhance sleep quality of intensive care patients. Methods Best evidence were identified through the evidence-based nursing approach to develop sleep management protocol, then 20 experts in critical care medicine and nursing were invited to participate in a two-round of consultation using the Delphi method. Results Twelve high-quality evidence were included, and the sleep management protocol was composed of five dimensions of insomnia diagnosis, sleep quality assessment, risk factors assessment, risk factors intervention and other measures to improve sleep quality, totaling to 11 items. The response rate of experts was 100%, the coefficient of authority of the experts was 0.84, the coefficients of variation ranged from 0.17 to 0.21, and the Kendall′s coefficient of concordance was 0.196 and 0.249 in the two rounds respectively ( P <0.01 for both). Conclusion The sleep management protocol is meticulously developed with high reliability for ICU patients, so it can be used to assess sleep quality of ICU patients after validation.

关 键 词：住院患者 ICU 失眠 睡眠管理方案 循证 德尔菲法 

分 类 号：R473.6[医药卫生—护理学] R471[医药卫生—临床医学]