老年肠造口患者术后早期衰弱预防护理方案的构建  

Construction of an early postoperative frailty prevention nursing program for elderly patients with enterostomy

作　　者：张亚娟 董芳辉 薛翌蔚 俞群亚 姚金秀 Zhang Yajuan;Dong Fanghui;Xue Yiwei;Yu Qunya;Yao Jinxiu(Department of Critical Care Medicine,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200130,China;Nursing Department,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200130,China;Department of Urinary Surgery,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200130,China)

机构地区：[1]上海交通大学医学院附属第六人民医院重症医学科,上海200130 [2]上海交通大学医学院附属第六人民医院护理部,上海200130 [3]上海交通大学医学院附属第六人民医院泌尿外科,上海200130

出　　处：《中华现代护理杂志》2023年第16期2166-2172,共7页Chinese Journal of Modern Nursing

基　　金：上海市护理学会优秀青年人才育苗计划(沪护会[2020]29号);中华医学会杂志社2021—2022年护理学科研究课题(CMAPH-NRI20211040);上海市第六人民医院院级科学研究基金项目(X-4313(LG))。

摘　　要：目的构建老年肠造口患者术后早期衰弱预防护理方案,为制订针对性照护方案提供依据。方法本研究的整体研究时间为2022年7—10月。以衰弱整合模式、跨文化护理理论为理论指导,通过文献研究、半结构式访谈,并结合前期横断面调查结果,初步构建老年肠造口患者术后早期衰弱预防护理方案内容框架指标。采用目的抽样法,选取来自全国7个省、直辖市的10所三级甲等医院的20名肠造口医学、护理专家,运用德尔菲法对20名专家进行2轮函询,确定老年肠造口患者术后早期衰弱预防护理方案。结果2轮专家函询问卷的有效回收率为100%(20/20),专家权威系数均为0.95,肯德尔和谐系数分别为0.23、0.32(P<0.05),各级指标的变异系数为0.050~0.167。最终构建的老年肠造口患者术后早期衰弱预防护理方案包含5个一级指标、23个二级指标、63个三级指标。结论本研究构建的老年肠造口患者术后早期衰弱预防护理方案具有科学性和必要性,可为护士对老年患者实施衰弱预防护理干预提供理论依据。Objective To construct an early postoperative frailty prevention nursing program for elderly patients with enterostomy,so as to provide a basis for formulating targeted nursing programs.Methods The overall research period was from July to October 2022.Guided by the frailty integration model and cross-cultural nursing theory,the content framework indicators of the early postoperative frailty prevention nursing program for elderly patients with enterostomy were initially constructed through literature research,semi-structured interviews,and combined with the results of the previous cross-sectional survey.A total of 20 gastroenterostomy and nursing experts from 10 ClassⅢhospitals in 7 provinces and municipalities were selected through the purposive sampling.Delphi method was used to carry out 2 rounds of consultation with 20 experts to determine the early postoperative frailty prevention nursing program for elderly patients with enterostomy.Results In the 2 rounds of expert consultations,the effective response rates of the questionnaire were all 100%(20/20),the expert authority coefficients were all 0.95,and the Kendall's W were 0.23 and 0.32 respectively(P<0.05).The coefficient of variation of indicators at all levels ranged from 0.050 to 0.167.The final early postoperative frailty prevention nursing program for elderly patients with enterostomy included 5 first-level indicators,23 second-level indicators,and 63 third-level indicators.Conclusions The early postoperative frailty prevention nursing program for elderly patients with enterostomy is scientific and necessary,and can provide a theoretical basis for nurses to implement frailty prevention and nursing for elderly patients.

关 键 词：肠造口术 结直肠癌 老年患者 衰弱 德尔菲法 

分 类 号：R473.73[医药卫生—护理学]