嵌合性抗原受体T细胞治疗血液肿瘤患者规范化护理体系的构建

Development of Standardized Nursing System for Patients with Hematologic Malignancies Treated by CAR-T Therapy

目的构建具有系统性、科学性、适用性的嵌合性抗原受体T细胞(chimeric antigen receptor,CAR-T)治疗血液肿瘤患者规范化护理体系,以期为开展CAR-T治疗提供规范化护理的依据。方法 2017年1月,成立医护技一体化的研究小组,查阅国内外相关文献、经相关专家反复探讨建立草案,应用德尔菲法,对13位相关临床医疗、护理专家进行了两轮专家函询,建立了"CAR-T治疗的规范化护理体系"。结果两轮函询问卷的有效回收率为100%,权威系数(Cr)分别为0.93、0.94,专家协调系数(W)分别为0.336、0.402,具有统计学意义(P<0.05);确立了包括评估、技术操作、并发症预防护理、健康教育、心理干预、集成化管理等6项一级指标和34项二级指标组成的CAR-T治疗血液肿瘤患者规范化护理体系。结论 CAR-T治疗血液肿瘤患者规范化护理体系内容全面合理,构建过程科学,有一定适用性。

Objective To construct a systematic,scientific and applicable standardized nursing system for patients with hematologic malignancies treated with CAR-T therapy,in order to provide the basis for standardized nursing.Methods A medical and technical integration research group was set up to consult the relevant literature,and the draft was discussed by relevant experts repeatedly.Delphi technique was used to establish the standardized nursing system of CAR-T therapy through two rounds of experts’consultation with 13 experts involved.Results After two rounds experts’consultation,the effective response rate was 100%;Cr coefficients were 0.93,0.94,respectively;W coefficients were 0.336,0.402,which were statistically significant(P<0.05).The standardized nursing system for patients with hematologic tumor treated by CAR-T therapy was established with 6 first level indicators and 34 second level indicators.The six first level indicators were evaluation,technical operation,complication nursing,health education,psychological intervention and integrated management.Conclusions The standardized nursing system for patients with hematological tumor treated by CAR-T is comprehensive and reasonable in content.The construction process is scientific.Therefore,it is applicable in the clinic.