肿瘤内科患者入住康复护理床位标准总原则的研究

Study on the General Principle of Admission Criteria of Rehabilitation Nursing Beds for Medical Oncology Patients

目的制定肿瘤患者入住康复护理床位标准的总原则，确定肿瘤患者转诊分流的优先顺序。方法在文献回顾和对15名专家质性访谈及预试验的基础上．初步拟定专家函询问卷，应用Delphi技术对上海市20名肿瘤内科专家进行3轮问卷函询。结果肿瘤内科患者入住康复护理床位标准总原则的函询专家权威系数为0．8161，第三轮函询专家对一级条目意见的协调系数为0．6975、0．8637，二级条目变异系数0．0523-0．2934。二级奈目中，“营养不良患者”、“疼痛患者”和“最佳支持治疗作为推荐治疗的患者”的入住必要程度评分最高。结论专家对入住总原则的认可度高，意见相对集中，且专家的意见趋于一致，其中“营养不良，需要营养支持治疗”者、“疼痛，VAS评分≥7分，需要三级综合镇痛治疗”者和“最佳支持治疗作为推荐治疗的患者”应优先转诊．

Objective To develop the general principle of admission criteria of rehabilitation nursing beds for medical oncology patients, and to determine patients＇referral priority. Methods An initial semi-structured questionnaire was developed through literature review and semi-structured interviews. Twenty medical oncology experts in Shanghai were consulted through 3 rounds of correspondences, during which a Delphi method was used. Results The expert authority coefficient of the research was 0. 8161. After the 3rd round of correspondence, the expert coordinate coefficients of first level items were 0. 6975,0. 8637, and variation coeffi- cients of second level items ranged from 0. 0523 to 0. 2934. Among second level items, the scores of items of malnutrition patients, patients in pain and patients treated with best supportive methods as the recommended treatment were highest. Conclusion The experts have a high recognition about the general principle of admission criteria of rehabilitation nursing beds for medical oncology patients; their opinions were relatively consentaneous. Patients who have malnutrition and need nutritional therapy, who are in pain, the scores of VAS are greater than 7, and need Three-Step Analgesia therapy have the highest priority for admission to rehabilitation nursing beds.