基于Delphi法筛选腰椎间盘突出症患者围手术期护理工作量项目的研究

Study on applying Delphi method for screening nursing workload items in the perioperative period of patients with lumbar disc herniation

目的应用Delphi法筛选腰椎间盘突出症患者围手术期护理工作量项目，为开展单病种护理成本核算提供科学依据。方法在文献查阅和专家小组讨论基础上初步设计护理工作量测量项目，然后运用Delphi法进行2轮专家咨询。结果2轮专家咨询回收有效咨询表分别为35份和37份，有效回收率分别为89％和94％，充分反映专家对本研究的支持；2轮咨询专家权威系数均数分别为0．79、0．88，说明专家咨询结果可信度较高；2轮咨询术前，术中／术后护理项目专家总的协调系数分别为0．265／0．305／0．359和0．435／0．316／0．425，差异显著。表明该研究咨询专家的意见趋于一致，协调程度好。结论科学有效地筛选腰椎间盘突出症患者围手术期护理工作量测量项目，能够准确测量该病种护理工作量，为进一步核算护理成本奠定基础。

Objective To screen nursing workload items in the perioperative period of lumbar disc herniation by using Delphi method for providing scientific basis in order to undertake nursing care cost calculation of single disease. Methods The measuring content of nursing workload was firstly designed on the basis of consulting literature and experts discussion,then two rounds of consultations were made with experts by using the Delphi method. Results Valid questionnaires collected back were 35 and 37,respectively,accounting for 89% and 94% in the two rounds of consultations with the experts, by which fully reflected the support of experts to the study. The average number of authoritative coefficients in the two rounds of consultations with the experts was respectively 0.79, 0.88,which indicated high reliability of the consulting. The overall coordination index for nursing care items in the preoperative/intraoperative/postoperative period of consulting experts respectively was 0.265/0.305/0.359 and 0.435-0.316-0.425,which had statistical significance and indicated the good coordination among the experts advice in determining the nursing care items and the desirability of the results. Conclusions Measurement items of nursing workload in perioperative period of lumbar disc herniation had been screened scientifically and reliably,which could accurately measure the nursing workload of the disease and lay the foundation for further accounting of nursing care cost.