基于循证和德尔菲法构建老年稳定性冠心病病人衰弱管理方案

Construction of frailty management plan for elderly patients with stable coronary heart disease based on evidence⁃based and Delphi method

目的:基于循证和德尔菲法构建老年稳定性冠心病病人衰弱管理方案。方法:基于循证原则系统筛选最佳证据,构建老年稳定性冠心病病人衰弱管理方案初稿,通过2轮德尔菲专家函询,对推荐证据与意见实施论证与修订后形成老年稳定性冠心病病人衰弱管理方案终稿。结果:形成了包括衰弱早期识别、衰弱管理干预、衰弱认知培训、衰弱出院计划4个模块、12个项目、63项操作性条目的老年稳定性冠心病病人衰弱管理方案。2轮专家函询问卷有效回收率均为100%,专家权威系数(Cr)分别为0.84好0.87,Kendall协调系数分别为0.235和0.268(均P<0.01)。结论:本研究形成的老年稳定性冠心病病人衰弱管理方案具有科学性和临床适用性,可为临床医护人员改善衰弱管理实践提供参考。

Objective:To construct frailty management plan for elderly patients with stable coronary heart disease based on evidence⁃based and Delphi method.Methods:Best evidence was screened systematically based on evidence⁃based principles for constructing first draft of frailty management plan for elderly patients with stable coronary heart disease.After two rounds of Delphi expert letter consultation,the recommended evidence and opinions were demonstrated and revised,the final frailty management plan for elderly patients with stable coronary heart disease was formed.Results:The frailty management plan for elderly patients with stable coronary heart disease was formed with 4 modules,12 items,and 63 operational items.The effective recovery rate of two rounds of expert letter inquiry papers both were 100%,the expert authority coefficient(Cr)were 0.84 and 0.87 respectively,and the Kendall coordination coefficient(W)values were 0.235 and 0.268,respectively(both P<0.01).Conclusions:The formed frailty management plan for elderly patients with stable coronary heart disease in this study is scientific and clinically applicable.It can provide references for clinical medical staff to improve frailty management practices.