基于COX-IMCHB的超低位直肠癌经括约肌间切除术患者自我管理干预方案构建  

Construction of COX-IMCHB Based Self-management Intervention Scheme for Patients with Ultra-low Rectal Cancer Undergoing Intersphincterectomy

作　　者：窦梦娇 贾汝福[2] 汤海燕 丁建华 李瑞博 姜红红 Dou Mengjiao;Jia Rufu;Tang Haiyan;Ding Jianhua;Li Ruibo;Jiang Honghong(College of Nursing and Rehabilitation,North China University of Science and Technology,Tangshan 063210,Hebei Province,China;Department of Nursing,Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China;Department of Nursing,Rocket Force Characteristic Medical Center,Beijing 100088,China;Medical Humanities Service Management Department,Genertec Universal Medical Group Company Limited,Beijing 100062,China)

机构地区：[1]华北理工大学护理与康复学院,河北唐山063210 [2]河北省沧州市中心医院护理部,河北沧州061017 [3]火箭军特色医学中心护理部,北京100088 [4]通用技术环球医疗集团有限公司医学人文服务管理部,北京100062

出　　处：《中国社区医师》2024年第25期121-124,共4页Chinese Community Doctors

基　　金：北京市科技计划课题(编号:Z211100002921044)。

摘　　要：目的:构建基于COX健康行为互动模式(COX-IMCHB)的超低位直肠癌经括约肌间切除术(ISR)患者自我管理方案。方法:以COX-IMCHB模式为理论基础,采用德尔菲法对6个省、直辖市的15位专家进行函询,形成干预方案。结果:专家参与程度100%,权威系数为0.92,Kendall's W系数为0.351(P<0.05)。干预方案围绕评估患者独特性要素、提供健康相关知识、情感支持、提供决策控制、患者健康结局5个维度,形成8个干预主题,涵盖16项干预内容,针对患者不同阶段的自我管理能力需求,给予相应的干预指导。干预方案的各项干预内容和措施的重要性评分均>3.5分,变异系数均<0.25。结论:基于COX-IMCHB构建的超低位直肠癌经括约肌间切除术患者自我管理干预方案具备一定的科学性、可靠性和可操作性,有助于提高患者自我管理能力。Objective:To construct a self-management scheme for patients with ultra-low rectal cancer undergoing intersphincterectomy(ISR)based on COX health behavior interaction model(COX-IMCHB).Methods:Based on COX-IMCHB model,fifteen experts from six provinces and municipalities were consulted by correspondence with Delphi method to form an intervention plan.Results:The degree of expert participation was 100%,the coefficient of authority was 0.92,and the coefficient of Kendall's W was 0.351(P<0.05);The intervention plan focused on 5 dimensions:evaluation of patients'unique elements,provision of health-related knowledge,emotional support,provision of decision-making control,and patient health outcomes,forming 8 intervention themes,covering 16 intervention contents,according to the needs of patients'self-management ability at different stages,corresponding intervention guidance is given;the importance scores of each intervention content and measure were all>3.5 points,and the coefficient of variation was<0.25.Conclusion:The COX-IMCHB based self-management intervention scheme for patients with ultra-low rectal cancer after sphincterectomy is scientific,reliable and operable,which is helpful to improve patients'self-management ability.

关 键 词：健康行为互动 直肠癌 经括约肌间切除术 自我管理 

分 类 号：R735.37[医药卫生—肿瘤]