脑卒中吞咽障碍患者护理质量评价指标的构建  

Establishment of a nursing quality evaluation indicator system for dysphagia patients after stroke

作　　者：郭园丽[1] 马珂珂 郭丽娜[1] 董小方[1] 杨彩侠[1] 吕培华[1] 高欢欢[2] GUO Yuanli;MA Keke;GUO Lina;DONG Xiaofang;YANG Caixia;LÜPeihua;GAO Huanhuan

机构地区：[1]郑州大学第一附属医院神经内科,郑州市450052 [2]郑州大学第一附属医院护理部,郑州市450052

出　　处：《中华护理杂志》2022年第13期1599-1605,共7页Chinese Journal of Nursing

基　　金：河南省医学科技攻关省部共建重点项目(SBGJ202002061)。

摘　　要：目的构建脑卒中吞咽障碍患者护理质量评价指标,为临床脑卒中吞咽障碍患者护理质量评价提供依据。方法以“结构-过程-结果”三维质量管理模型为理论基础,通过文献回顾和头脑风暴法构建评价指标初稿,2021年3月—5月通过2轮德尔菲专家咨询对指标进行增、删及修改,使用层次分析法确定指标权重。结果共对21名专家进行2轮专家咨询,问卷回收率分别为100%和95.23%,专家权威系数分别为0.958、0.964,肯德尔和谐系数分别为0.216、0.340(P<0.001),各级指标的重要性赋值均数为3.90~5.00分,最终构建的脑卒中吞咽障碍护理质量评价指标包括3个一级指标、9个二级指标和35个三级指标。结论该研究构建的脑卒中吞咽障碍患者护理评价指标科学、合理、全面且具有针对性,能够为脑卒中吞咽障碍患者的护理质量评价提供参考。Objective To establish a nursing quality evaluation indicator system for patients with dysphagia after stroke,and to provide a basis for clinical nursing quality evaluation.Methods The research group established the first draft of dysphagia patients nursing quality evaluation based on the framework of the three-dimensional“structure-process-result”quality management model by literature review and brainstorming method.From March to May 2021,the first draft was revised by 2 rounds of expert consultations through Delphi technique.The final nursing quality evaluation system and indicators weight were analyzed by analytic hierarchy process.Results 2 rounds of consultations were completed by 21 experts.The questionnaire recovery rates were 100%and 95.23%;the expert authority coefficients were 0.958 and 0.964,respectively.Kendell harmony coefficients were 0.216 and 0.340(P<0.001).The mean value of importance of each indicator ranged from 3.9 to 5.0.The final nursing quality indicators of stroke dysphagia included 3 first-level indicators,9 second-level indicators(human resource allocation,equipment and facilities,management system,nursing evaluation,nursing practice,health education,follow-up management,nurse outcome,patient outcome)and 35 third-level indicators.Conclusion The nursing evaluation indicators system of stroke patients with dysphagia are scientific,reasonable,comprehensive and targeted,and it can provide references for nursing quality evaluation of stroke patients with dysphagia.

关 键 词：脑卒中 吞咽障碍 德尔菲技术 护理质量审核 护理评价研究 护理管理研究 

分 类 号：R473.74[医药卫生—护理学]