基于出院准备度构建脊髓损伤患者延续护理需求指标体系

Construction of the continuous nursing need index system based on discharge readiness for patients with spinal cord injury

目的基于出院准备度构建脊髓损伤患者延续护理需求指标体系,旨在指导临床护理实践。方法采用便利抽样方法,选取2017年1月—2018年7月在青岛市某三级甲等医院脊柱外科住院的115例脊髓损伤患者为研究对象,应用出院准备度量表对其进行调查。基于调查结果,初步构建脊髓损伤患者延续护理需求指标体系,采用德尔菲法遴选25名专家进行2轮咨询,确立最终脊髓损伤患者延续护理需求指标体系。结果115例脊髓损伤患者的出院准备度总分为(60.39±22.12)分,条目均分为(5.27±2.75)分。2轮函询专家的权威系数分别为0.78和0.81,协调系数分别为0.343和0.423,第2轮专家函询中各条目的变异系数为0.09~0.18。最终构建了包括5个一级指标和33个二级指标的脊髓损伤患者延续护理需求指标体系。结论本研究构建的脊髓损伤患者延续护理需求指标体系专家权威系数高,具有一定的科学性和实用性,可为脊髓损伤患者出院健康指导提供依据,促进患者从医院-社区-家庭的安全过渡和全面康复。

Objective To construct the continuous nursing need index system based on discharge readiness for patients with spinal cord injury so as to guide the clinical nursing practice.Methods From January 2017 to July 2018,this study selected 115 spinal cord injury inpatients of Spine Surgery Department at a ClassⅢGrade A hospital in Qingdao as subjects by convenience sampling.The Readiness for Hospital Discharge Scale(RHDS)was used to investigate those patients.According to the investigation results,this study primarily built the continuous nursing need index system for spinal cord injury patients.Delphi method was used to select 25 experts for two rounds of consultation so as to establish the final the continuous nursing need index system for spinal cord injury patients.Results Among 115 spinal cord injury patients,the total score and item average score of RHDS were(60.39±22.12)points and(5.27±2.75)points respectively.Among two rounds of consultation,the authoritative coefficients of experts were 0.78 and 0.81 respectively,and the coordination coefficients were 0.343 and 0.423.In the second round of consultation,the variation coefficients ranged from 0.09 to 0.18.The final the continuous nursing need index system for spinal cord injury patients included 5 first-level indexes and 33 second-level indexes.Conclusions The continuous nursing need index system for spinal cord injury patients has a high level of authoritative coefficients and is scientific practical which can provide a basis for discharge health instruction in spinal cord injury patients and promote the safe transition in hospital-community-family as well as comprehensive rehabilitation.