老年髋部骨折手术患者超早期肢体活动方案的构建  

Construction of an ultra-early limb movement program for elderly hip fracture surgery patients

作　　者：陈静茹 孙占颖 甘雪洋 宋咪 宋杰[2] 高远[2] Chen Jingru;Sun Zhanying;Gan Xueyang;Song Mi;Song Jie;Gao Yuan(Graduate School,Chinese People's Liberation Army(PLA)Medical School,Beijing 100853,China;Department of Nursing,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院研究生院,北京100853 [2]解放军总医院第一医学中心护理部,北京100853

出　　处：《中华现代护理杂志》2024年第34期4688-4695,共8页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金(72204262);国家重点研发计划(2022YFC2504300)。

摘　　要：目的基于循证和德尔菲法构建老年髋部骨折手术患者超早期肢体活动方案。方法2023年5—12月,采用"PIPOST"模型构建循证问题,检索国内外相关数据库,获取、汇总、评价老年髋部骨折手术患者超早期肢体活动相关证据,制订活动方案初稿,检索时限为建库至2023年6月1日。邀请29名专家进行2轮德尔菲专家函询,形成老年髋部骨折手术患者超早期肢体活动方案终稿。结果共纳入文献20篇,其中指南6篇、专家共识4篇、系统评价3篇、原始研究7篇。2轮专家函询问卷回收率分别为100.00%(29/29)、86.21%(25/29),专家权威系数分别为0.931和0.920,Kendall协调系数分别为0.205和0.112(均P<0.01)。最终形成4个模块、39个操作性条目的老年髋部骨折患者超早期肢体活动方案。结论本研究基于循证方法结合专家函询法构建了老年髋部骨折患者超早期肢体活动方案,具有必要性、科学性和实用性,可以为临床工作人员开展髋部骨折手术患者超早期活动提供参考和指导。ObjectiveTo construct an ultra-early limb movement program for elderly hip fracture surgery patients based on evidence-based practice and the Delphi method.MethodsFrom May to December 2023,the PIPOST Model(population,intervention,professional,outcome,setting,type of evidence)was used to develop evidence-based questions.Relevant databases were searched to obtain,summarize,and evaluate evidence related to ultra-early limb movement after hip fracture surgery in elderly patients.A draft of the movement program was created with the search timeline set until June 1,2023.A total of 29 experts were invited to participate in two rounds of Delphi expert consultation to finalize the ultra-early limb movement program for elderly hip fracture surgery patients.ResultsA total of 20 studies were included,consisting of six guidelines,four expert consensuses,three systematic reviews,and seven original research articles.The response rates for the two rounds of Delphi expert consultation were 100.00%(29/29)and 86.21%(25/29).The expert authority coefficients were 0.931 and 0.920,and the Kendall coordination coefficients were 0.205 and 0.112(all P<0.01).The final ultra-early limb movement program for elderly hip fracture surgery patients included four modules and 39 operational items.ConclusionsThis study develops an evidence-based,expert-validated ultra-early limb movement program for elderly hip fracture surgery patients,demonstrating its necessity,scientific basis,and practicality.The program provides a reference and guidance for clinical staff in facilitating ultra-early movement for hip fracture patients post-surgery.

关 键 词：康复护理 髋部骨折 肢体活动 超早期 循证护理 德尔菲法 

分 类 号：R473.6[医药卫生—护理学]