永久性起搏器植入术病人康复管理指标体系的构建

Establishment of rehabilitation management index system for patients with permanent pacemaker implantation

[目的]构建永久性起搏器植入术病人康复管理指标体系,提高病人术后的生活质量。[方法]成立多学科研究团队,以循证以医养护一体化政策为依托结合过渡期护理服务模式初步确立永久性起搏器植入术病人康复管理体系的相关指标。然后采用德尔菲专家咨询法,构建永久性起搏器植入术病人康复管理体系。[结果]两轮专家咨询问卷回收率分别为95.6%和100.0%,权威系数分别为0.92和0.93;一级指标的肯德尔和谐系数为0.453,二级指标的肯德尔和谐系数为0.350,均P<0.05,专家意见趋于一致。确立的永久性起搏器植入术病人康复管理体系包括个体化健康评估、健康管理、围术期护理要点、康复服务、健康教育、社区家庭病床服务、远程健康监控管理、双向转诊8个一级指标、43个二级指标。[结论]构建的永久性起搏器植入术病人康复管理体系具有科学性和连续性,有利于规范永久性起搏器植入术病人术后康复管理理论和流程。

Objective:To establish the rehabilitation management index system for patients with permanent pacemaker implantation,in order to improve the quality of life of patients.Methods:A multidisciplinary research team was established to build a rehabilitation management system through the evidence-based strategy,based on the"integrated medical and nursing"policy and combined with the transitional nursing service model.Then Delphi expert consultation method was used to construct the rehabilitation management system for patients with permanent pacemaker implantation.Results:The positive coefficient of two rounds of expert consultation were 95.6%and 100.0%respectively,and the authoritative coefficients were 0.92 and 0.93 respectively.Kendall’s W of the first level index was0.453.The Kendall’s W of the second level index was 0.350,both P<0.05.The expert opinions tended to be consistent.The established rehabilitation management index system for patients with permanent pacemaker implantation included eight first-level indicators and 43 second-level indicators.The first-level indicators contained individual health assessment,health management,perioperative nursing points,rehabilitation services,health education,community home sickbed services,remote health monitoring and management,two-way referral.Conclusion:The constructed rehabilitation management index system for patients with permanent pacemaker implants was scientific and continuous,which was conducive to standardizing the theory and process of postoperative rehabilitation management.