基于循证与德尔菲法构建住院糖尿病足患者运动方案

Construction of exercise program for inpatients with diabetic foot based on evidence-based and Delphi method

目的采取循证和德尔菲法构建住院糖尿病足患者运动方案,为临床实践提供指导。方法系统检索BMJ最佳临床实践、UpToDate、加拿大安大略注册护士协会等国内外数据库和专业协会网站中有关糖尿病足患者运动管理的证据,检索时限为建库至2021年4月,对纳入的文献质量进行评价,并对符合质量标准的文献进行证据提取和汇总,形成住院糖尿病足患者运动方案初稿,通过2轮德尔菲专家函询,对方案条目进行修订,形成适合临床的住院糖尿病足患者运动方案终稿。结果2轮专家函询问卷有效回收率均为15/15,专家权威系数分别为0.865和0.895,Kendall协调系数分别为0.232和0.291(均P<0.01)。形成了包括糖尿病足患者运动评估、运动处方、运动中监测、运动后评价、运动管理5个模块、12个项目、40项操作性条目的住院糖尿病足患者运动方案。结论本研究构建的住院糖尿病足患者运动方案,具有科学性和临床适用性,可以为临床医护人员开展糖尿病足患者运动实践提供科学指导。

Objective The evidence-based and Delphi methods were used to construct the exercise program for hospitalized patients with diabetes foot to provide guidance for clinical practice.Methods Evidence on exercise management of diabetic foot patients was systematically searched from BMJ Best Practice,UpToDate,Registered Nurses′Association of Ontario and other domestic and foreign databases and professional association websites.The retrieval period was from the establishment of the database to April 2021.The quality of the included literature was independently evaluated,and the evidence of the literature meeting the quality standards was extracted and summarized to form the first draft of exercise program for inpatients with diabetic foot.After two rounds of Delphi expert letter consultation,the program items were revised,and the final draft of the exercise program for inpatients with diabetic foot suitable for clinical practice was formed.Results The effective recovery rate of the two rounds of expert correspondence questionnaire both were15/15.The expert authority coefficient was 0.865 and 0.895 respectively.And the Kendall coordination coefficient was 0.232 and 0.291(both P<0.01).An exercise program for inpatients with diabetic foot had been formed,including 5 modules(exercise evaluation,exercise prescription,exercise monitoring,post-exercise evaluation and exercise management),12 items and 40 operational items.Conclusions The exercise program for inpatients with diabetic foot constructed in this study is scientific and clinically applicable,which provide scientific guidance for clinical medical staff to carry out exercise practice.