基于奥马哈系统肺癌化疗患者延续性护理评价体系的构建

Construction of transitional care evaluation system for lung cancer patients with chemotherapy based on Omaha system

目的基于奥马哈系统构建肺癌化疗患者延续性护理评价体系。方法基于文献研究,结合奥马哈系统、内容分析、交叉映射法以及专家小组会议初步拟定肺癌化疗患者延续性护理评价体系初稿,采用德尔菲专家咨询法,2019年1-3月,对15例来自肿瘤医疗、肿瘤护理领域的专家进行2轮专家函询,最后形成肺癌化疗患者延续性护理评价体系。2019年4-5月,选取某肿瘤专科医院30例肺癌化疗患者对延续性护理评价体系内容进行重要性评定。专家的积极性用问卷有效回收率表示,专家权威性采用专家权威系数(Cr)表示,专家意见协调程度采用变异系数和肯德尔协调系数表示,意见的集中程度采用重要性赋值表示。结果2轮专家咨询问卷回收率均为100%,第2轮专家函询Cr为0.80,一、二级指标肯德尔协调系数分别为0.300和0.160(P<0.001),专家、患者评定意见均趋于一致,最终构建的肺癌化疗患者延续性护理评价体系包括一级指标8项、二级指标62项。结论本研究构建的肺癌化疗患者延续性护理评价体系内容科学、合理,可为有效实施肺癌化疗患者延续性护理服务提供参考依据。

Objective To construct transitional care evaluation system for lung cancer patients with chemotherapy based on Omaha systemtheory.Methods Based on literature research,the first draft of transitional care evaluation system for lung cancer patients with chemotherapy was preliminarily formulated by combining Omaha system,content analysis,cross-mapping method and expert group meeting.By using Delphi expert consultation method,15 experts from the field of oncology medicine and oncology nursing were conducted two rounds of expert consultation from January 2019 to March 2019.Finally,the transitional care evaluation system for lung cancer patients with chemotherapy was formed.From April 2019 to May 2019,30 lung cancer patients with chemotherapy in a cancer specialist hospital were selected to evaluate the importance of the contents of the transitional care nursing evaluation system.The enthusiasm of experts was expressed by the effective recovery rate of the questionnaire,the authority of experts was expressed by the expert authority coefficient(Cr),the coordination degree of expert opinions was expressed by the coefficient of variation and Kendall coordination coefficient,and the concentration degree of opinions was expressed by the value of importance.Results The recovery rates of the two rounds of expert consultation questionnaires were 100%.The expert authority coefficient of the second round of expert consultation was 0.80.Kendall's coordination coefficients of the first-levelindicators and second indicators were 0.300 and 0.160 respectively(P<0.001).The evaluation opinions of experts and patients tended to be consistent.The transitional care evaluation system for lung cancer patients with chemotherapy was finally constructed,including 8 first-level indicators and 62 second-level indicators.Conclusions In this study,contents of transitional care evaluation system for lung cancer patients with chemotherapy are scientific and reasonable,which can provide a reference for the effective implementation of transitional care for lung cancer patients with chemotherapy.