摘要
目的构建针对自体造血干细胞移植患者护理问题评估体系。方法以奥马哈问题分类系统为理论框架,通过文献回顾及临床调查,结合自体造血干细胞移植患者的特点,应用德尔菲法构建自体造血干细胞移植患者护理评估体系。结果自体造血干细胞移植患者护理评估体系包括一级指标4项、二级指标35项、三级指标125项。2轮专家咨询问卷回收率分别为100%和93.3%;专家权威系数为0.90与0.89;协调系数为0.322~0.510,协调系数检验均具有统计学意义(P<0.01);从权重来看,环境领域“卫生”和“收入”权重值较高(0.2798、0.2757);心理社会领域“准备水平”权重值最高(0.1623),其次是“照顾”(0.1599)和“心理健康”(0.1551);生理领域“移植并发症”和“中心静脉导管维护”权重值最高(0.0669),其次是“骨髓功能”(0.0660);健康相关行为领域“感染预防”权重值最高(0.1319),其次是“用药方案”(0.1300)、“随访及复发监测”(0.1281)。结论自体造血干细胞移植患者护理评估体系具有可靠性,有利于临床移植护士全面有效评估患者护理问题及科学合理的制定个性化护理计划。
Objective To establish an assessment system for the health problems of patients undergoing Autologous Hematopoietic Stem Cell Transplantation(AHSCT).Methods The study was based on the Problem Classification Scheme of Omaha System. The assessment system was constructed by literature review and clinical investigations, combing with the characteristics of AHSCT patients.A two-round Delphi survey was used for the construction of nursing assessment system.Results The assessment system for the health problems of AHSCT patients was composed of 4 primary indicators, 35 secondary indicators, and 125 tertiary indicators. The questionnaire recovery rate of the two-round expert consultations were 100% and 93.3%,The authority coefficients were 0.90 and 0.89, the Kendall’s concordance coefficients of all indicators were ranged from 0.322 to 0.510,and the Kendall’s test had statistical significance(P<0.01).In terms of weights, sanitationand income showed the higher weight value(0.279 8,0.275 7)of environmental domain, "preparation level" and "caretaking" showed the hightest value(0.162 3,0.159 9)of psychosocial domain, "transplant complications" and "central venous catheter maintenance" showed the highest value(0.066 9)of physiological domain, followed by "bone marrow function"(0.066 0),infection prevention showed the highest value(0.131 9) of health-related behaviors domain, followed by medication regimen(0.130 0), follow-up and recurrence monitoring(0.128 1). Conclusion The constructed assessment system for the health problems of AHSCT patients is reliable, which is helpful for clinical transplant nurses to assess the nursing problems of AHSCT patients comprehensively and effectively.
作者
冯丽娜
贺瑾
冯莉霞
刘金嫚
朱晓萌
孙莎莎
FENG Lina;HE Jin;FENG Lixia;LIU Jinman;ZHU Xiaomeng;SUN Shasha(Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center of Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)
出处
《护士进修杂志》
2022年第9期787-791,共5页
Journal of Nurses Training
基金
天津市卫生健康科研项目资助(编号:KJ20118)。
关键词
奥马哈问题分类系统
自体造血干细胞移植
护理评估
problem classification scheme of omaha system
autologous hematopoietic stem cell transplantation(AHSCT)
nursing assessment
