消化系统癌症患者术后早期下床活动安全性评估工具的构建及诊断效能评价  

Construction and Evaluation of Diagnostic Efficiency of A Safety Assessment Tool in Postopera-tive Early Ambulation with Gastrointestinal Cancer Patients

作　　者：刘婷婷 陈敏 沈玲[2] LIU Tingting;CHEN Min;SHEN Ling(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong Univer-sity School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学护理学院,上海200025 [2]上海交通大学医学院附属新华医院普外科,上海200092

出　　处：《解放军护理杂志》2020年第8期36-39,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：上海交通大学医学院附属新华医院护理亚专科建设项目(xhhlzkjs2018-08)。

摘　　要：目的构建消化系统癌症术后早期下床活动安全性评估工具,并评价其诊断效能。方法采用文献内容分析法、头脑风暴法和Delphi法构建评估工具,并对200例消化系统癌症术后患者进行早期活动风险评估调查研究。结果构建的评估工具包括2个维度,即患者因素、医源性因素,共12个条目,总分值在12~29分之间。ROC曲线下面积为0.951[95%CI(0.919,0.984)],最佳临界值为17分,对应的灵敏度为0.961,特异度为0.852,阳性预测值为69.01%,阴性预测值为98.45%,Kappa系数为0.649[95%CI(0.481,0.797)]。结论本研究构建的评估工具有助于筛查消化系统癌症术后早期下床活动存在风险的患者,可为早期活动的安全性管理提供参考。Objective To construct a safety assessment tool for postoperative early ambulation among gas-trointestinal cancer patients,and to evaluate its diagnostic efficiency.Methods The literature analysis,brainstorming,and the Delphi method were used to establish a preliminary tool,and the risk assessment of early ambulation in 200 patients with gastrointestinal cancer surgery was investigated.Results The tool in-cluded two dimensions(patient factors and iatrogenic factors)and twelve items,and the total score ranged from 12 to 29 points.The area under the ROC curve was 0.951[95%CI(0.919,0.984)],and the optimal cut-off value was 17 points.The corresponding sensitivity,specificity,positive predictive and negative predictive value of the tool were 0.961,0.852.69.01%and 98.45%,respectively.Inter-rater agreement had a kappa value of 0.649[95%CI(0.481,0.797)].Conclusions The tool constructed by this study will contribute to screening patients with risks of early ambulation after gastrointestinal cancer surgery and provide a refer-ence for the safety management of early am bulation.

关 键 词：消化系统癌症 早期下床活动 评估工具 诊断性试验 患者安全 

分 类 号：R473.57[医药卫生—护理学]