基于故事理论构建康复期乳腺癌病人延续照护模式

Construction of continuous care model of breast cancer patients in the rehabilitation period based on story theory

[目的]以故事理论为基础,构建康复期乳腺癌病人延续照护模式,为肿瘤病人的延续照护管理提供依据。[方法]通过病人延续性服务需求调查表,结合查阅文献及半结构式访谈形成初步指标框架,经过两轮专家咨询,确定基于故事理论的延续照护模式的各级指标。[结果]两轮专家积极系数为100%,专家权威系数(Cr)为0.84,0.91,专家协调系数为0.401,0.486;第2轮专家咨询后一级指标变异系数为0.063~0.152,二级指标变异系数为0.036~0.193;三级指标变异系数为0.022~0.191。最终确定5项一级指标、24项二级指标、53项三级指标,共计82项条目的以故事理论为基础,病人参与的照护模式,包括评估倾听、实施路径、正性引导、照护干预、效果评价5个方面内容。[结论]本研究为肿瘤病人延续照护模式的制定提供了本土化依据。

Objective:Based on the story theory,to construct a continuous care model for breast cancer patients during the rehabilitation period,and to provide empirical evidence for the management of continuous care in cancer patients.Methods:Through the patient continuous service demand questionnaire,combined with literature review and semi-structured interviews,a preliminary indicator frame was formed.After two rounds of expert consultation,the indicators of all levels of the continuous care model based on story theory were determined.Results:The positive coefficients of experts in two rounds were both 100%.The authoritative coefficient of experts Cr were 0.84 and 0.91.The expert coordination coefficients were 0.401 and 0.486.After the second round of experts consultation,the coefficient of variation of the first-level index were form 0.063 to 0.152.And the coefficients of variation of the second-level index were form 0.036 to 0.193.The coefficient of variation of the three-level index were form 0.022 to 0.191.The continuous care model based on story theory,combined with patients′participation,was finally determined,including 5 first-level indicators,24 second-level indicators,and 53 third-level indicators(a total of 82 items),involving five aspects:listening assessment,implementation path,positive guidance,care intervention,and effect evaluation.Conclusions:This study could provide a localized basis for the development of the continuous care model for cancer patients.