脑卒中后失眠循证护理实践方案的构建  

Development of evidence-based practice protocols for post-stroke insomnia

作　　者：王欣琦 朱颖[2] 蔡梦怡 张美洁 张伟英[3] Wang Xinqi;Zhu Ying;Cai Mengyi;Zhang Meijie;Zhang Weiying(School of Medicine,Tongji University,Shanghai 200092,China;School of Nursing,Medical College of Soochow University,Suzhou 215000,China;Department of Nursing,East Hospital Affiliated to Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学医学院,上海200092 [2]苏州大学护理学院,苏州215000 [3]同济大学附属东方医院护理部,上海200120

出　　处：《中国实用护理杂志》2024年第24期1841-1847,共7页Chinese Journal of Practical Nursing

基　　金：上海现代护理职业教育集团特聘兼职教师项目(hlzjtpgr202331);上海市浦东新区卫生系统领先人才培养计划(PWRl2020-10);中国研究型医院学会科研课题(Y2022FH-HLJY05-04);同济大学医学院学科建设三年行动计划重点学科项目(JS2210103)。

摘　　要：目的构建脑卒中后失眠(PSI)循证护理实践方案,为脑卒中患者实施失眠护理提供参考。方法于2022年1月组建研究小组,基于循证原则系统检索、汇总PSI相关的西医护理、中医护理的高质量证据拟定PSI循证护理实践方案初稿,邀请脑卒中的护理、医疗、科研教学领域的专家,通过2轮德尔菲专家函询,修订方案内容,形成PSI循证护理实践方案终稿。结果共邀请15名专家,男3名,女12名;年龄31~40岁2名,41~50岁6名,51~60岁7名。2轮专家函询积极系数均为100%,专家权威系数为0.89;2轮函询条目重要性和可行性评分的Kendall协调系数分别为0.188、0.146和0.224、0.188(均P<0.01)。PSI循证护理实践方案包括睡眠质量的评估、PSI诊断、制订个体化计划、非药物干预、中医护理干预、出院准备及随访6个维度27个条目。结论PSI循证护理实践方案具有科学性、可靠性和适用性,可为PSI患者的护理实践提供参考。ObjectiveTo develop a post-stroke insomnia(PSI)evidence-based nursing practice protocol to provide reference for the implementation of insomnia nursing in stroke patients.MethodsIn January 2022,a research team was formed.Based on evidence-based principles,systematically searched and summarized high-quality evidence of Western medicine care and Chinese medicine care related to PSI to develop the first draft of the evidence-based nursing practice protocol for PSI,invited medical experts and nursing experts in the field of stroke care,medical treatment,research and teaching,and the protocol was revised through 2 rounds of Delphi expert consultation to form the final draft of the protocol.ResultsA total of 15 experts were invited,3 males and 12 females;2 between 31 and 40 years of age,6 between 41 and 50 years of age,and 7 between 51 and 60 years of age.The positive coefficient for both rounds of expert consultation was 100%and the expert authority coefficient was 0.89;the Kendall coordination coefficients for the importance and feasibility scores of the entries in the 2 rounds expert consultation were 0.188 and 0.146,0.224 and 0.188(all P<0.01).The PSI evidence-based nursing practice protocol included 27 entries in 6 dimensions:assessment of sleep quality,diagnosis of PSI,development of an individualized plan,non-pharmacological interventions,Chinese medicine nursing interventions,preparation for discharge and follow-up.ConclusionsThe PSI evidence-based nursing practice protocol is scientific,reliable and applicable,and can provide a reference for the nursing practice of PSI patients.

关 键 词：卒中 失眠 循证护理 护理方案 德尔菲法 

分 类 号：R473.74[医药卫生—护理学]