体外膜肺氧合患者肢体功能锻炼方案的构建  

Development of a limb function exercise program for patients on extracorporeal membrane oxygenation

作　　者：卢梦洁 史苏霞[3] 曹燕华[4] 林嘉鳞[5] Lu Mengjie;Shi Suxia;Cao Yanhua;Lin Jialin(Blood Purification Room,Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi 214000,China;School of Medicine,Tongji University,Shanghai 200092,China;Outpatient and Emergency Offices,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China;Department of Respiratory and Critical Care,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China;Department of Nursing,Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi 214000,China)

机构地区：[1]南京中医药大学附属无锡市中医医院血液净化室,无锡214000 [2]同济大学医学院,上海200092 [3]同济大学附属上海市肺科医院门急诊办公室,上海200433 [4]同济大学附属上海市肺科医院呼吸与危重症监护室,上海200433 [5]南京中医药大学附属无锡市中医医院护理部,无锡214000

出　　处：《中华现代护理杂志》2024年第31期4216-4223,共8页Chinese Journal of Modern Nursing

基　　金：上海市护理学会面上项目(2021MS-B04)。

摘　　要：目的构建体外膜肺氧合(ECMO)患者肢体功能锻炼方案,为临床护理工作者提供理论指导。方法成立研究小组,系统检索国内外ECMO患者功能锻炼相关文献,提取相关证据形成ECMO患者肢体功能锻炼方案初稿。于2023年6—7月,运用德尔菲法对来自上海市、江苏省、山西省3个省、直辖市的18名专家进行2轮专家函询,根据专家意见对方案条目进行修改,形成方案终稿。结果第1轮函询了18名专家,问卷有效回收率为94.44%(17/18);第2轮函询了17名专家,问卷有效回收率为100.00%(17/17)。2轮函询专家权威系数均为0.859。第2轮函询各级指标的变异系数为0~0.160,各级指标的肯德尔和谐系数为0.092~0.130(P<0.01)。最终构建的ECMO患者肢体功能锻炼方案包括准备、评估、运动方法、安全监测4项一级指标、13项二级指标、44项三级指标。结论本研究构建的ECMO患者肢体功能锻炼方案具有科学性和可靠性,可为ECMO患者肢体功能锻炼的实施提供借鉴和指导。ObjectiveTo develop a limb function exercise program for patients on extracorporeal membrane oxygenation(ECMO)and provide theoretical guidance for clinical nursing staff.MethodsA research team was formed to systematically review domestic and international literature on functional exercise for ECMO patients,extracting relevant evidence to form the initial version of the limb function exercise program.From June to July 2023,the Delphi method was used to conduct two rounds of expert consultations with 18 experts from three provinces and municipalities directly under the central government,including Shanghai,Jiangsu,and Shanxi.Based on the experts'feedback,the program items were revised to form the final version of the exercise program.ResultsIn the first round,18 experts were consulted,with a valid response rate of 94.44%(17/18);in the second round,17 experts participated,with a 100.00%(17/17)response rate.The expert authority coefficient was 0.859 in both rounds.The coefficient of variation for each level of indicator in the second round ranged from 0 to 0.160,and Kendall's coefficient of concordance was 0.092 to 0.130(P<0.01).The final ECMO patient limb function exercise program consisted of four primary indicators(preparation,assessment,exercise methods,and safety monitoring),13 secondary indicators,and 44 tertiary indicators.ConclusionsThe ECMO patient limb function exercise program developed in this study is scientifically sound and reliable,offering a reference and guidance for the implementation of limb function exercises for ECMO patients.

关 键 词：体外膜肺氧合 肢体 功能锻炼 方案 德尔菲技术 

分 类 号：R472[医药卫生—护理学]