放射性皮肤溃疡评估工具的构建  

Construction of assessment tool for radiation-induced skin ulcer

作　　者：刘成伟 刘亦凡 黄瑶[1] 王齐 倪鹏文[1] 谢挺[1] LIU Cheng-wei;LIU Yi-fan;HUANG Yao;WANG Qi;NI Peng-wen;XIE Ting(Department of Emergency(South),Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院急诊科(南部),上海200011

出　　处：《上海交通大学学报（医学版）》2020年第12期1687-1692,共6页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的·构建放射性皮肤溃疡评估工具,获得放射性皮肤溃疡临床评价标准,从而根据评价结果制定最佳治疗方案。方法·通过文献回顾,参考包括糖尿病足、压力性损伤、下肢血管溃疡伤口评估工具的设计逻辑,讨论后设计调查问卷,并运用2轮德尔菲专家咨询法对创面修复相关领域16名专家进行咨询。通过调查问卷的反馈结果分析专家协调系数、专家积极系数及专家权威系数,检验专家咨询的可靠性及放射性皮肤溃疡评估工具的统一性、科学性,从而完成放射性皮肤溃疡评估工具的构建。结果·经过13名专家2轮评估,初步构建了包含2个一级指标、10个二级指标、35个三级指标的放射性皮肤溃疡评估工具。经德尔菲专家咨询可靠性分析,2轮咨询专家积极性分别为87.50%和100%。专家组个人权威系数为0.8~1.0,专家群体权威系数为0.937。2轮咨询专家肯德尔协调系数分别为0.231和0.147,差异有统计学意义(χ2=131.977和χ2=87.849,均P<0.05)。结论·专家对该研究的积极性高,权威性可靠,专家评估意见协调性好,结果可信。构建的放射性皮肤溃疡评估工具科学、可靠,临床可操作性强,能够用于临床评估。Objective·To initiate an assessment tool for radiation-induced skin ulcer and reach a standardized assessment for clinical use,so as to contribute to the determination of optimal therapy depending on the assessment.Methods·A questionnaire was designed by reviewing the literatures,referring to the logic of assessment tools of wound diseases including diabetic foot ulcer,pressure injury and lower extremity vascular ulcer,and discussing within the research group.Sixteen experts in wound healing were engaged in the consultation over two rounds of Delphi method.The expert concordance coefficient and expert positive coefficient as well as expert authority coefficient was analyzed by checking the feedback.The reliability of experts'consultation,as well as the coordination and scientificity with assessment tool were analyzed statistically.Then the assessment tool for radiation-induced skin ulcer was established.Results·Thirteen of 16 experts responded over the two rounds consultation.The established assessment tool for radiationinduced skin ulcer contains 2 first-level indicators,10 second-level indicators and 35 third-level indicators.Within the two rounds of consultation,the positive coefficient were 87.50%and 100%respectively.The expert authority coefficient was 0.937.The Kendall's coefficient of concordance for two rounds consultation were 0.231 and 0.147 respectively(χ2=131.977 andχ2=87.849,P<0.05).Conclusion·Experts showed high enthusiasm toward this research,and had reliable authority.The expert evaluation opinions were well coordinated,thus the results were credible.The established assessment tool for radiation-induced skin ulcer was verified to be scientific and reliable.The tool is easy to be used in clinic.By use of this assessment tool,the therapeutic plan of radiation-induced skin ulcer could be made in a more standardized way.

关 键 词：放射性皮肤溃疡 伤口评估工具 德尔菲专家咨询法 

分 类 号：R758.1[医药卫生—皮肤病学与性病学]