恶性肿瘤患儿化疗后感染风险评估表的研制

A study on the development of a sheet to assess infection risks in children with malignant tumors after chemotherapy

目的研制恶性肿瘤患儿化疗后感染风险评估表（以下简称评估表）。方法采用自行设计并经预实验修订的评估表（咨询版）为研究工具，以遴选的6省市9所医院儿童肿瘤医疗专家、儿童肿瘤护理专家与感染控制专家共24名为对象，先后进行了3轮专家咨询，形成评估表（试用版），经临床试用与调整，形成了评估表（应用版）。结果（1）研究所选专家的权威系数平均为0．79，积极系数为1．00与0．96，协调系数为0．22与0．34。（2）经3轮专家咨询形成的评估表（试用版）包括静态项目评估与动态项目评估2大维度共30条项目。（3）经临床试用后精简与调整，评估表（应用版）将静态项目评估维度精简为8条项目并更名为基础免疫状态评估维度，将动态项目评估维度精简为16条项目并更名为感染风险筛查维度。结论（1）研究所选专家具有良好的代表性、权威性与积极性。（2）通过3轮专家咨询与临床试用，评估表（应用版）具有较好的针对性与实用性。（3）评估表（应用版）的临床实效有待进一步验证。

Objective To develop a sheet to assess infection risks in children with malignant tumors after chemotherapies. Methods A risk assessing sheet （to consult） was designed and used to consult 24 experts from 9 hospitals located in 6 provinces. After 3 rounds of expert consuhation, a sheet （to try） was developed and tried by nurses in the clinic. And then a sheet （to use） was developed. Results The au- thority coefficient of experts was 0.79, the positive coefficient of experts was 1.00 and 0.96. The sheet （to try） developed after 3 rounds of expert consultation consisted of 30 items and was divided into 2 parts, one was about static items and the other was about dynamic items. Depending on the trying of the sheet （to try）, the sheet （to use） was constituted by 8 fundamental immune state assessing items and 16 infection risk screening items. Conclusions Experts consulted in the study were quite reliable, representative and positive. The sheet （to use） seemed to have good pertinence and practicability. Further studies should be done to verify whether the sheet （to use） may help nurses to prevent children with malignant tumors from infections after chemotherapies.