以家庭为中心儿童1型糖尿病个案管理照护方案的构建

Construction of the family-centered case management program for children with type 1 diabetes

目的:构建以家庭为中心的儿童1型糖尿病个案管理照护方案。方法:基于文献研究、临床调研,结合自我管理理论、奥马哈成效评价系统拟定以家庭为中心的儿童1型糖尿病个案管理照护方案初稿,选取我国6个地区19名专家进行两轮德尔菲专家函询,对各级指标进行统计分析和筛选,并通过计算专家的积极系数、权威系数和协调系数,分析专家咨询结果的可信度。结果:两轮专家函询问卷有效回收率分别为95.0%和100.0%,权威系数分别为0.89和0.87,Kendall’s W值均有统计学意义(P<0.001),各级指标的集中程度较高。最终得到以家庭为中心的儿童1型糖尿病个案管理照护方案,包括以家庭为中心的儿童1型糖尿病个案管理工作流程和成效评价指标(5个一级指标、14个二级指标和34个三级指标)。结论:以家庭为中心的儿童1型糖尿病个案管理照护方案具有较高的可信度和科学性,可为儿童1型糖尿病的管理提供参考与借鉴。

Objective:To construct a family-centered case management program for children with type 1 diabetes.Methods:Based on literature reviews and clinical investigation,a draft of the family-centered case management program for children with type 1 diabetes was developed with self-management theory and Omaha effectiveness evaluation system as a reference.Then 19 experts from 6 regions in China were selected to join in the two rounds of Delphi expert letter consultation and conduct statistical analysis and screening of indicators at all levels.The credibility of expert consultation results was analyzed by calculating the positive coefficient,authority coefficient and coordination coefficient of experts.Results:The effective recovery rates of the two rounds of expert correspondence questionnaire were respectively 95.0%and 100.0%with the authoritative coefficient being 0.89 and 0.87,and the Kendall’s W values were all statistically significant(P<0.001).The concentration of various indicators was relatively high.Finally,the family-centered case management program for children with type 1 diabetes was obtained,including the family-centered case management working process and evaluation indicators which were consisted by 5 first-level ones,14 second-level ones and 34 third-level ones.Conclusion:The family-centered case management program for children with type 1 diabetes is of significant credibility and feasibility,which can provide guidance and references for the nursing of children with type 1 diabetes.