基于德尔菲法的生前预嘱示范文本标准化研究  

Research on the standardization of living will model texts based on the Delphi method

作　　者：陈泓君 董文阅 付佳霖 王宣匀 王丁熠 王岳[1] CHEN Hongjun;DONG Wenyue;FU Jialin;WANG Xuanyun;WANG Dingyi;WANG Yue(School of Health Humanities,Peking University,Beijing 100191,China;School of Basic Medical Sciences,Peking University,Beijing 100191,China;School of Law,Peking University,Beijing 100871,China)

机构地区：[1]北京大学医学人文学院,北京100191 [2]北京大学基础医学院,北京100191 [3]北京大学法学院,北京100871

出　　处：《中国医学伦理学》2025年第4期512-521,共10页Chinese Medical Ethics

基　　金：北京市法学会“北京市安宁疗护与生前预嘱地方立法研究”[BLS(2023)B020]。

摘　　要：目的 结合现有文献基础和生前预嘱实施现状,结合现代医学特点制定适合中国推广的标准化生前预嘱手册。方法 通过医院访谈和文献检索构建手册条目池,并进行德尔菲法专家函询,对手册条目设置进行修改、补充,对函询结果进行统计学分析来验证手册及函询的可靠性、科学性。结果 研究对北京市四家医院进行访谈,检索并纳入155篇文献构建手册条目池,设计医疗、心理、社会、告别四部分共40项条目,制定初版手册。通过面向两轮共88名专家的德尔菲法函询,进行手册条目的修订。两轮函询问卷的专家积极系数分别为100%、90%;专家权威程度分别为0.84、0.865;肯德尔和谐系数分别为0.141、0.077。在信度检验方面,两轮函询的Cronbach’s α系数分别为0.941、0.969,Guttman折半系数分别为0.862、0.857。在效度检验方面,一轮函询39个条目的皮尔逊相关系数R>0.4,二轮函询41个条目的皮尔逊相关系数R>0.4;一轮共20个条目I-CVI≥0.780,量表的S-CVI=0.786;二轮函询共31个条目I-CVI≥0.780,量表的S-CVI=0.846。与此同时,研究通过查阅相关法律法规,制定了包括个人信息、生效时间、修改撤销、见证人等内容的手册法律文书部分。结论 标准化生前预嘱手册内容涵盖全面,可靠性、科学性强,适宜进行推广并进一步改进。Objective:To develop a standardized living will manual suitable for promotion in China,combining existing literature and the current implementation status of living will both domestically and internationally as well as the characteristics of modern medicine.Methods:A pool of manual entries was constructed through hospital interviews and literature retrieval.A Delphi method expert correspondence was conducted to modify and supplement the manual entry settings.The results of the correspondence were statistically analyzed to verify the reliability and scientific validity of the manual and the correspondence.Results:This study constructed a pool of manual entries by conducting interviews in four hospitals in Beijing and retrieving and including 155 pieces of literature,and developed a preliminary version of the manual with a total of 40 entries in four sections,namely medicine,psychology,society,and farewell.The manual items were revised through two rounds of the Delphi method correspondence with a total of 88 experts.The expert response rates in the two rounds of the correspondence questionnaires were 100%and 90%,respectively;the expert authority coefficients were 0.84 and 0.865,respectively;and Kcndall W was 0.141 and 0.077,respectively.In terms of the reliability test,the Cronbach’sαcoefficients of the two rounds of correspondence were 0.941 and 0.969,respectively,and the Guttman coefficients were 0.862 and 0.857,respectively.As for the validity test,the Pearson correlation coefficient for 39 entries was R>0.4 in the first round of correspondence,and for 41 entries was R>0.4 in the second round of correspondence;a total of 20 entries in the first round of correspondence had an I-CVI≥0.780,and the scale’s S-CVI was 0.786;a total of 31 entries in the second round of correspondence had an I-CVI≥0.780,and the scale’s S-CVI was 0.846.Meanwhile,this study developed a legal instrument section of the manual including personal information,effective time,modification and revocation,witnesses,and other contents by

关 键 词：生前预嘱 全人健康 德尔菲法 专家函询 

分 类 号：R-052[医药卫生]