德尔菲法构建肿瘤医院ICU患者身体约束评估量表

Construction of the Body Restraint Assessment Scale for Patients in ICU of Tumour Hospital by Delphi

目的运用德尔菲法和优序图法构建适合肿瘤医院ICU使用的身体约束评估量表,为制定我国ICU身体约束护理指南和标准提供依据。方法采用文献回顾、半结构式访谈形成条目池,运用德尔菲法选取广州、天津、长沙、成都、昆明5地三甲医院的26名专家进行两轮函询,确定评估条目,采用优序图法确定条目权重并结合临床实际情况对量表进行赋分,形成最终版量表。结果两轮专家函询的积极系数均为100%;专家权威系数分别为0.916、0.910;专家意见协调系数分别为0.309(χ^(2)=104.379,P<0.001)、0.349(χ^(2)=81.687,P<0.001);权重系数排名前五位的是:谵妄、镇静躁动程度、自伤自杀风险,疼痛、合作程度。最终形成包含10个一级条目40个等级条目的肿瘤医院ICU患者身体约束评估量表。结论经德尔菲和优序图法构建的肿瘤医院ICU身体约束评估量表具有较好的信度和效度,可作为身体约束的有效决策工具。

Objective To develop the body restraint assessment scale for patients in ICU of tumour hospital by Delphi and Optimal Sequence Diagram,to provide the basis for the develop ICU body restraint nursing guidelines and standard.Methods Literature review and semi-structured interviews were used to form an item pool.Delphi was used to select 26 experts from Grade 3 A hospitals in Guangzhou,Tianjin,Changsha,Chengdu and Kunming to carry out two rou-nds of consultionto determine the items.The weight result of items determin-ed by Optimal Sequence Diagram was assigned score combined with clinical practice,to form the final scale.Results Both of the two rounds of the positive factors that experts determined were 100%.The authority factors were 0.916 and 0.910 respectively.The coo-rdination coefficients by experts’opinion were 0.309(χ^(2)=104.379,P<0.001)and 0.349(χ^(2)=81.687,P<0.001),The top five weight coefficients were delirium,degree of sedation-agitation,risk of suicide,pain and cooperation,which eventually formed a body constraint assessment scale containing 10 first itemsand 40 level items in tumor hospital ICU.Conclusion The body restraint assessment scale of patients in ICU of tumor hospital has good reliability and validity,which can be used as a effective tool for evaluating the body constraint of patients in ICU of tumor hospital.