区域医联体内脑卒中患者向下转诊过渡期护理模式的构建

Construction of transitional care model for downward referral of stroke patients in regional medical alliance

目的 构建区域医联体内脑卒中患者向下转诊过渡期护理模式,以满足脑卒中患者延续护理需求。方法 以过渡期护理模式理论及人口-能力-过程模型为框架,结合文献分析、质性访谈及德尔菲专家函询法,构建区域医联体内脑卒中患者向下转诊过渡期护理模式。邀请18名专家参与2轮函询。结果 2轮专家函询问卷回收率分别为100%、94.4%;专家权威系数分别为0.867、0.868;肯德尔和谐系数分别为0.118、0.267(均P<0.05)。第2轮函询各条目变异系数为0~0.204。最终确定的区域医联体内脑卒中患者向下转诊过渡期护理模式包括5个维度(实施机构、人员配备、关键环节、实施路径、效果评价)、23个一级条目和60个二级条目。结论 构建的区域医联体内脑卒中患者向下转诊过渡期护理模式内容全面,构建过程严谨规范,可供医护人员为脑卒中患者在不同机构间的过渡护理提供实践依据。

Objective To construct a transitional care model for downward referral of stroke patients in regional medical alliance,so as to meet transitional care needs of stroke patients.Methods Based on the transitional care model and population-capacity-process framework,literature review,qualitative interview,and Delphi expert consensus method were used to develop the transitional care model of downward referral of stroke patients in regional medical alliance.Eighteen experts were invited to participate in a two-round consultation.Results The response rate of the experts was 100%in round 1 and 94.4%in round 2.The expert authority coefficients were 0.867 and 0.868,respectively.The Kendall′s coefficients of concordance(W)were 0.118 and 0.267,respectively(both P<0.05).The coefficient of variation for each item ranged from 0 to 0.204 in round 2.The final version of the transitional care model for downward referral of stroke patients in regional medical alliance included 5 dimensions,namely implementing agencies,staffing,key procedure,implementing paths,and effect evaluation,totaling 23 primary items and 60 secondary items.Conclusion This innovative transitional care model for downward referral of stroke patients in regional medical alliance is comprehensive,rigorous and normative,which will enable medical staff to provide transitional care for stroke patients in different institutions.