肺通气功能障碍住院患者相关护理方案的构建

Construction of nursing programs for inpatients with pulmonary ventilation dysfunction

目的：基于《护理措施分类》初步确定不同肺通气功能障碍住院患者所需的护理措施及护理活动类目,以指导临床护理实践。方法于2014年3—8月通过查阅肺通气功能循证指南及相关临床实践文献,对肺通气功能障碍患者进行临床跟踪,以《护理措施分类》为蓝板,编写不同功能状态的护理措施和活动类目,形成专家咨询问卷；对6名临床护理专家初步咨询后,对临床22名呼吸科护理专家进行两轮专家咨询。结果两轮咨询专家权威系数平均为0.80,专家积极系数分别为95.83%和100．00%。最终筛选出通气功能相关31条护理措施及259个活动类目,其中通气功能极重度30条（252个）、重度20条（143个）、中重度19条（103个）、中度6条（25个）、轻度5条（19个）。入选护理措施的专家一致性为90.9%～100%；入选的护理活动条目的赋值均数为4.00～5.00分、变异系数为0～0.25。结论初步确定的肺通气功能相关的护理方案,较系统全面,利于交流,可用于指导临床护理实践。

Objective To preliminarily identify the nursing interventions and activities for inpatients with pulmonary ventilation dysfunction in different levels based on Nursing Interventions Classification （NIC）. Methods Evidence-based clinical practices and literatures about nursing activities of patients with ventilation dysfunction were reviewed, and took full advantage of their function with clinical follow-up. Firstly, 6 clinical nursing specialists were consulted by a questionnaire survey, which was based on the initial screened nursing interventions and activities from NIC. Then, 22 experts were consulted twice. Results The expert authority coefficient was 0. 80 on average and the positive coefficient of experts were 95. 83% and 100. 00%. The established nursing programs related to function included 31 interventions and 258 activities which ranging from extremely severe to mild was 30 （ 252 ） , 20 （ 143 ） , 19 （ 103 ） , 6 （ 25 ） , 5 （ 19 ） , respectively. The nursing specialists consistency of selected interventions was 90. 9% to 100%. The selected activities scored 4. 00 to 5. 00 in average, with the coefficient of variations ranging from 0 to 0. 25. Conclusions The preliminarily established nursing interventions and activities are easy to communicate and can guide the clinical nursing practice.