基于奥马哈问题分类系统构建主动脉夹层术后病人康复期随访指标  

Constructing follow-up indicators for postoperative patients with aortic dissection based on the Omaha problem classification system

作　　者：郑栋莲 吉双对 马富珍[1] 马世林 张竹英[1] 郭淑萍[1] ZHENG Donglian;JI Shuangdui;MA Fuzhen;MA Shilin;ZHANG Zhuying;GUO Shuping(General Hospital of Ningxia Medical University,Ningxia 750004 China)

机构地区：[1]宁夏医科大学总医院,宁夏750004

出　　处：《循证护理》2025年第6期1045-1051,共7页Chinese Evidence-Based Nursing

基　　金：2022年宁夏回族自治区重点研发计划项目,编号:2022BEG03095;宁夏回族自治区第七批青年科技人才托举工程项目,编号:宁科协发组字〔2023〕6号。

摘　　要：目的:构建主动脉夹层(AD)术后病人随访指标,规范病人康复期随访管理内容,及时发现并解决病人疾病康复期的健康相关问题,为制定和完善AD病人随访支持决策提供参考。方法:基于奥马哈问题分类系统,结合文献分析及半结构式访谈提取AD术后病人康复期随访护理需求,初步形成随访指标。于2022年12月—2023年2月选取16名专家进行2轮函询,形成AD术后病人随访指标体系,根据专家意见修订后形成终稿。结果:2轮函询专家的积极系数分别为88.89%、93.75%;专家权威系数为0.900、0.919;肯德尔和谐系数为0.223、0.467(均P<0.001)。最终形成包含4个一级指标、18个二级指标、51个三级指标的AD术后病人康复期随访指标。结论:本研究构建的AD术后病人康复期随访指标的科学性、实用性较强,能为临床护理人员开展随访工作及健康教育支持决策提供参考。Objective:To construct follow-up indicators for patients with aortic dissection(AD)after surgery,standardize the management of patient follow-up during the rehabilitation period,timely discover and solve health-related problems during the disease recovery period,and provide reference for formulating and improving follow-up support decisions for AD patients.Methods:Based on the Omaha problem classification system,combined with literature analysis and semi-structured interviews,the follow-up nursing needs of AD postoperative patients during the rehabilitation period were extracted,and preliminary follow-up indicators were formed.From December 2022 to February 2023,16 experts were selected for two rounds of letter consultation to form a follow-up index system for patients after AD surgery,and the final draft was revised according to expert opinions.Results:The positive coefficients of two rounds of consultation were 88.89%and 93.75%,respectively.The expert authority coefficient was 0.900 and 0.919.Kendall harmony coefficient was 0.223,0.467(P<0.001).Finally,a follow-up index of AD patients'rehabilitation period was formed,which included 4 primary indexes,18 secondary indexes and 51 tertiary indexes.Conclusion:The follow-up indexes established in this study are scientific and practical,which can provide reference for clinical nurses to carry out follow-up work and support health education decision-making.

关 键 词：主动脉夹层 康复期 指标体系 问题分类系统 随访 德尔菲技术 护理 

分 类 号：R47[医药卫生—护理学]