老年结直肠癌术后患者全方位健康管理方案的构建  

Construction of a Comprehensive Health Management Program for Elderly Postoperative Colorectal Cancer Patients

作　　者：周瑾 王雁[2] 王卉 张宜南 智晓旭 张致远 徐德静[1] 周欣[1] 张柳柳 ZHOU Jin;WANG Yan;WANG Hui;ZHANG Yinan;ZHI Xiaoxu;ZHANG Zhiyuan;XU Dejing;ZHOU Xin;ZHANG Liuliu(The Affiliated Cancer Hospital of Nanjing Medical University/Jiangsu Cancer Hospital/Jiangsu Institute of Cancer Reaserch,Nanjing 210009,China;Fudan University Shanghai Cancer Center,Shanghai 200000,China)

机构地区：[1]南京医科大学附属肿瘤医院,江苏省肿瘤医院江苏省肿瘤防治研究所,江苏省南京市210009 [2]复旦大学附属肿瘤医院,上海市200000

出　　处：《中国全科医学》2024年第21期2600-2606,2616,共8页Chinese General Practice

基　　金：江苏省科技厅重点研发计划(BE2020723);江苏省老年健康科研项目(LKM2023009)。

摘　　要：背景 老年群体结直肠癌患病率高、病情复杂,术后康复面临着诸多问题。构建科学、实用、全面的老年结直肠癌术后健康管理方案对提升患者健康水平具有重要意义。目的 构建老年结直肠癌术后患者全方位健康管理方案,为老年结直肠癌患者术后康复提供参考。方法 基于文献研究和质性访谈构建老年结直肠癌术后患者全方位健康管理方案初稿,采用德尔菲法对来自南京、上海三级甲等医院的16名专家开展2轮函询。专家积极程度采用问卷回收率和文字修改率评价,专家权威程度用权威系数评价,专家意见的协调程度用变异系数和肯德尔和谐系数评价。整合专家意见并由研究小组讨论后,调整条目内容形成老年结直肠癌术后患者全方位健康管理方案终稿。结果 2轮专家函询问卷回收率分别为94.12%和100.00%,专家文字修改率均为56.25%,专家权威系数为0.91;第1轮专家函询各条目的重要性赋值范围为3.81~5.00分,变异系数为0~0.24;第2轮专家函询各条目的重要性赋值范围为4.13~5.00分,变异系数为0~0.20;2轮专家函询肯德尔和谐系数分别为0.211和0.222(P<0.001),且第2轮函询结果较第1轮有所提高。经2轮专家函询和研究小组讨论,最终形成包含9个一级条目(团队建立、心理支持、体力活动、造口护理、营养干预、中医康复技术、同伴教育、治疗与随访、自我管理)和39个二级条目的老年结直肠癌术后患者全方位健康管理方案。结论 本研究构建的老年结直肠癌术后患者健康管理方案具有较好的科学性、可靠性、适用性和实用性,可为老年结直肠癌患者术后康复提供指引。Background The elderly colorectal cancer population has a high prevalence and complex condition,and postoperative rehabilitation faces various challenges.It is of great significance to construct a scientific,practical and comprehensive postoperative health management program for colorectal cancer in the elderly to improve patients' health.Objective To construct a comprehensive health management program for elderly postoperative colorectal cancer patients,and provide reference for postoperative rehabilitation of elderly colorectal cancer patients.Methods Based on literature review and qualitative interviews,the management program for elderly postoperative colorectal cancer patients was initially formulated.The Delphi method was used to conduct 2 rounds of correspondence with 16 experts from tertiary hospitals in Nanjing and Shanghai.The motivation degree of the experts was evaluated based on questionnaire recovery rate and text revision rate.Furthermore,the authority coefficient was used to evaluate the degree of expert authority,while the coefficient of variation and Kendall's W coefficient were used to evaluate the coordination of expert opinions.Based on opinions and discussion of experts,the ultimate formation of the health management program for elderly postoperative colorectal cancer patients was constructed after adjusting the content of entries.Results The recovery rates of the two rounds of expert correspondence were 94.12% and 100.00%,respectively.The text revision rates were 56.25%,and the authority coefficient was 0.91.The mean importance scores of items in the two rounds of the consultation ranged from 3.81 to 5.00 and 4.13 to 5.00,with the coefficients of variation from 0 to 0.24 and 0 to 0.20.The Kendall's W coefficients of expert opinions were 0.211 and 0.222,respectively(P<0.001),with an improvement observed in the second round compared to the first round.After two rounds of expert correspondence and the expert group discussion,the final management program for elderly postoperative colorectal canc

关 键 词：结直肠肿瘤 结直肠癌 健康管理 老年人 全方位 德尔菲法 

分 类 号：R735.34[医药卫生—肿瘤]