应用德尔菲法构建Ⅲ期、Ⅳ期糖尿病肾病病人中西医结合延续护理方案

Application of Delphi method for constructing continuity of care program of integrated traditional Chinese and Western medicine for stageⅢ and Ⅳ diabetic nephropathy patients

[目的]构建Ⅲ期、Ⅳ期糖尿病肾病病人中西医结合延续护理方案。[方法]采用德尔菲法对14名肾病内科、内分泌科的医疗和护理专家进行专家咨询,共2轮。[结果]2轮专家咨询问卷回收率均为100%,2轮专家的权威系数分别是0.815和0.895,协调系数分别是0.30和0.37;共筛选出125个条目(删6条,修订17条,增加2条),其中一级条目17条,二级条目43个,三级条目65个;两轮专家咨询后确定了本次方案中糖尿病肾病中医症候标准、随访实施路径、健康教育内容及居家胰岛素和血糖测量操作规范及中医护理居家操作手册共6个方面的内容。[结论]构建的中西医结合延续护理方案包括糖尿病肾病中医症候标准、随访实施路径、健康教育内容及居家胰岛素和血糖测量操作规范及中医护理居家操作手册6个方面,为延续护理本土化研究提供了思路。

Objective：To construct the continuous nursing program of integrated traditional Chinese and Western medicine for stageⅢ andⅣ diabetic nephropathy（DN）patients.Methods：2rounds of expert consultation were carried out for 14 medical and nursing specialists in departments of internal medicine and endocrinology by using Delphi method.Results：The recovery rate of experts in 2rounds consultation questionnaire was 100%,the authority coefficient of experts in 2rounds were 0.815 and 0.895,coordination coefficient were 0.30 and 0.37;125items（deleted 6,revised 17,increased 2）were selected,in which 17 first class entries,43 second class entries,65 third class entries;after two rounds of expert consultation,six aspects of contents were identified including the diabetic nephropathy standard of TCM syndrome group,follow-up implementation path,health education,the operation standard of insulin and blood glucose measurement at home and operation manual of TCM nursing at home of DN in this program.Conclusion：The continuity of care program of integrated traditional Chinese and Western medicine included six aspects of the diabetic nephropathy standard of TCM syndrome group,follow-up implementation path,health education,the operation standard of insulin and blood glucose measurement at home and operation manual of TCM nursing at home,and provided a way for the localization study of continuity of care.