基于德尔菲法的慢性阻塞性肺疾病急性加重期院内肺康复方案的制定

Using Delphi method to establishment a pulmonary rehabilitation program during hospitalization for patients with acute exacerbation of chronic obstructive pulmonary disease

目的通过德尔菲专家咨询法制定COPD急性加重期患者的院内肺康复方案。方法通过德尔菲专家咨询法,遴选16位来自呼吸、康复、运动等领域的专家,经过2轮专家咨询,并进行预实验研究,确立了包括康复安全性指标,上、下肢锻炼,呼吸锻炼,健康教育在内的院内肺康复方案。结果 2轮专家咨询,专家积极系数为100%,群体权威系数为0. 812,各条目重要性评分均> 3. 5分,各条目变异系数均<0. 25,计算2轮专家Kendall’s W和谐系数分别为0. 167和0. 103,结果具有统计学意义(P <0. 05)。预实验研究结果显示,5例患者依从性良好,无不良事件发生。结论本研究制定的COPD急性加重期院内肺康复方案具有较好的科学性、可行性和安全性,可供临床应用参考。

Objective To develop a set of pulmonary rehabilitation programs for hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods The Delphi expert consensus method was conducted to select 16 experts, and 2 rounds of experts consultation and preliminary experiment were performed. The hospitalized pulmonary rehabilitation programs were established, including of safety index,upper and lower limb exercise,breathing exercise and health education. Results After 2 rounds of experts consultation, the positive coefficient were all 100.00%, the authority coefficient was 0.812,the importance score of each item was over 3.5, the coefficient of variation was below 0.25. The Kendall＇s W coordination coefficient of the expert opinions was 0.167 in first round 0.103 in second round, with a significantdifference （ P 〈0.05）. The preliminary experiment showed a good compliance of programs in five patients, without any adverse events. Conclusion The hospitalized pulmonary rehabilitation programs were scientific, feasible, and could be applied to clinical practice.