晚期心力衰竭患者安宁疗护准入评估指标的构建  

Construction of an assessment index system of palliative care referral for patients with advanced heart failure

作　　者：张辰 杨浩杰 张哲 李茹 季诗明 胡宇乐 周彦君 梁涛[4] ZHANG Chen;YANG Haojie;ZHANG Zhe;LI Ru;JI Shiming;HU Yule;ZHOU Yanjun;LIANG Tao

机构地区：[1]中国医学科学院阜外医院护理部,北京市100037 [2]中国医学科学院阜外医院内科重症病区ICU,北京市100037 [3]中国医学科学院阜外医院心衰重症监护病房,北京市100037 [4]中国医学科学院北京协和医学院护理学院

出　　处：《中华护理杂志》2023年第13期1544-1551,共8页Chinese Journal of Nursing

基　　金：中国医学科学院阜外医院青年科研基金(2022-FWQN20)。

摘　　要：目的构建晚期心力衰竭患者安宁疗护准入评估指标,为安宁疗护准入决策提供参考。方法于2022年4月—11月,通过文献回顾、半结构式访谈、专家函询及层次分析法,确定晚期心力衰竭患者安宁疗护准入评估指标的内容及权重。结果2轮专家函询的有效问卷回收率分别为91.43%、93.75%,专家权威系数分别为0.869、0.875;各级指标的肯德尔和谐系数分别为0.136~0.244、0.120~0.214(均P<0.001)。最终构建的晚期心力衰竭患者安宁疗护准入评估指标包括4个一级指标、12个二级指标和44个三级指标。结论该研究构建的晚期心力衰竭患者安宁疗护准入评估指标全面、具体,具有较好的科学性和适用性,可指导医护人员早期、准确地对晚期心力衰竭患者进行安宁疗护准入评估。Objective To establish an assessment index system of palliative care referral for patients with advanced heart failure,and to provide references for decision-making of palliative care referral.Methods From March to November 2022,literature review,semi-structured interview,Delphi method and analytic hierarchy process were used to determine the index system of palliative care referral evaluation for patients with advanced heart failure and the weight of each index.Results The effective recovery rates of the 2 rounds of correspondence were 91.43%and 93.75%,and the coefficient of expert authority were 0.869 and 0.875,respectively.The Kendall harmony coefficients of the 2 rounds of correspondence were 0.136~0.244 and 0.120~0.214(P<0.001).Finally,the index system of palliative care referral assessment for patients with advanced heart failure was constructed,including 4 first-level indexes,12 second-level indexes and 44 third-level indexes.Conclusion The index system of palliative care referral assessment for patients with advanced heart failure established in this study is comprehensive and specific,with good science,reliability and practicability,which could guide medical staff to conduct early and accurate palliative care referral assessment for patients with advanced heart failure.

关 键 词：心力衰竭 安宁疗护 护理评估 指标 德尔菲技术 层次分析法 

分 类 号：R473.5[医药卫生—护理学]