康复期神经源性膀胱患者结构化教育课程的构建  

Construction of structured education course for patients with neurogenic bladder during rehabilitation period

作　　者：张鹤立 胡娴静 戴宏乐[1] 韩舒羽 罗永梅[4] 耿荣梅[2] 李葆华[2] Zhang Heli;Hu Xianjing;Dai Hongle;Han Shuyu;Luo Yongmei;Geng Rongmei;Li Baohua(Department of Rehabilitation Medicine,Peking University Third Hospital,Beijing 100191,China;Nursing Department,Peking University Third Hospital,Beijing 100191,China;School of Nursing,Peking University Beijing 100191,China;Department of Neurology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院康复医学科,北京100191 [2]北京大学第三医院护理部,北京100191 [3]北京大学护理学院,北京100191 [4]北京大学第三医院神经内科,北京100191

出　　处：《中华现代护理杂志》2024年第25期3416-3423,共8页Chinese Journal of Modern Nursing

基　　金：北京大学第三医院院护理科研基金(BYSYHL2020015)。

摘　　要：目的构建康复期神经源性膀胱患者结构化教育课程。方法本研究包括现况调查、文献检索、专家函询3个阶段。2022年2月-2023年2月对62例神经源性膀胱患者自我管理需求进行现况调查;2023年4月开展文献检索,对神经源性膀胱护理、管理等最佳证据进行汇总,形成课程指标及内容初版;2023年4-5月选择14名专家进行函询,采用德尔菲法对课程指标及内容进行论证,构建课程终稿。结果纳入62例神经源性膀胱患者存在对饮水管理、膀胱功能训练、饮食要求等的迫切需求。文献检索共检索到2053篇文献,最终纳入14篇文献,包括8篇指南、4篇证据总结、1篇专家共识、1篇系统评价。2轮专家函询的专家权威系数分别为0.93和0.92,第2轮专家函询各级指标的肯德尔协调系数为0.227~0.288(P<0.01)。经过2轮专家函询,最终形成包括6个一级指标、21个二级指标和30个三级指标的康复期神经源性膀胱患者结构化教育课程。结论本研究基于现况调查、高质量证据和专家函询形成了康复期神经源性膀胱患者结构化教育课程,内容全面,设置合理,可以为未来神经源性膀胱患者健康教育和膀胱管理提供支持性帮助。Objective To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods This study consisted three stages of current situation survey,literature search,and expert consultation.From February 2022 to February 2023,a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder.In April 2023,a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder,and form the initial version of course indicators and content.From April to May 2023,14 experts were selected for consultation,and the Delphi method was used to demonstrate the course indicators and content,and to construct the final draft of the course.Results A total of 62 patients with neurogenic bladder were included,they have requirements for water management,bladder function training,and dietary requirements,etc.A total of 2053 articles were retrieved,and 14 articles were ultimately included,including eight guidelines,four evidence summaries,one expert consensus,and one systematic review.The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92,respectively.The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288(P<0.01).After two rounds of expert consultation,a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed,including six primary indicators,21 secondary indicators,and 30 tertiary indicators.Conclusions The structured education course for patients with neurogenic bladder during the rehabilitation period,based on current situation survey,high-quality evidence,and expert consultation,is comprehensive in content and reasonably designed,which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.

关 键 词：神经源性膀胱 康复期 健康教育 结构化课程 德尔菲法 

分 类 号：R473.6[医药卫生—护理学]