肺癌患者术后肺部感染预防护理方案的构建及验证  

Construction and validation of a postoperative lung infection prevention care program for lung cancer patients

作　　者：郑娉婷 纪超娜[2] 王逸如[1] 陈惜遂[3] ZHENG Pingting;JI Chaona;WANG Yiru;CHEN Xisui

机构地区：[1]汕头大学医学院附属肿瘤医院护理部,汕头市515041 [2]汕头大学医学院第一附属医院胆胰微创外科 [3]汕头大学医学院第一附属医院护理部

出　　处：《中华护理杂志》2024年第7期820-827,共8页Chinese Journal of Nursing

摘　　要：目的构建肺癌患者术后肺部感染预防护理方案并进行初步验证,为临床护理提供参考依据。方法采用文献分析法,检索国内外数据库、指南网、协会网站,检索时限为2011年1月至2021年12月,获取相关证据,构建肺癌患者术后肺部感染预防护理方案初稿,并采用德尔菲专家函询法,于2022年9月—12月对广东省、河南省、四川省的专家进行函询,确定方案终稿。2023年11月—12月,选取汕头市某三级甲等医院15名胸外科护士及15例肺癌患者进行方案的初步应用,并通过护士对方案的临床意义、适用性、可行性评价以及患者满意度等评价方案效果。结果共21名专家完成2轮函询。2轮函询中,问卷回收率分别为95.65%、95.45%;专家的权威系数分别为0.941、0.948;肯德尔和谐系数分别为0.176、0.310;第2轮函询中,各条目的变异系数为0.04~0.25。方案终稿包括团队合作、健康教育、风险评估、康复训练、液体管理、口腔管理、气道管理、营养管理、疼痛管理、管路管理等10个方面,37项措施。方案初步应用后,100%的护士认为该方案很有意义,87%的护士认为该方案很具有临床适用性、可行性,100%的患者表示对该方案满意,其中80%的患者表示很满意。结论构建的肺癌患者术后肺部感染预防护理方案具有科学性、针对性和可行性,可为临床医护人员制订预防肺癌患者术后肺部感染措施提供参考。Objective To construct a postoperative lung infection preventive care program for lung cancer patients and carry out preliminary validation,so as to provide a reference basis that can be used in clinical practice.Methods Literature analysis was carried out to search domestic and international databases,guideline networks,and association websites,with a search timeframe of January 2011 to December 2021,to obtain relevant evidence,to construct a preliminary draft of a preventive care program for postoperative lung infections in patients with lung cancer,and to use the Delphi method of correspondence with experts from Guangdong Province,Henan Province,and Sichuan Province,September-December 2022,to determine the content of the program.Correspondence to determine the content of the program.In November-December 2023,15 thoracic surgery nurses and 15 lung cancer patients in a tertiary hospital in Shantou City were selected for the initial application of the program and evaluated the effectiveness of the program through the nurses’clinical significance,applicability,feasibility,and patient satisfaction.Results A total of 21 experts completed 2 rounds of correspondence.95.65%and 95.45%of questionnaires were returned in the 2 rounds of correspondence;the authority coefficients of the experts were 0.941 and 0.948;the Kendall’s harmony coefficients were 0.176 and 0.310;the coefficients of variation for each item in the 2nd round of correspondence were 0.04~0.25.The final draft of the program included 10 aspects and 37 measures,such as teamwork,health education,risk assessment,rehabilitation training,fluid management,oral manage-ment,airway management,nutritional management,pain management,line management,and other 10 areas with 37 measures.After the initial application of the program,100%of the nurses thought that the program was meaningful,87%of the nurses thought that the program was clinically applicable and feasible,and 100%of the patients indicated that they were satisfied with the program,of which 80%were very sat

关 键 词：肺癌 肺部感染 德尔菲技术 护理方案构建 预防管理 

分 类 号：R473.73[医药卫生—护理学]