基于德尔菲法改良先天性心脏病患儿术后早期分级康复护理模式

Based on Delphi method improved early graded rehabilitation nursing model for postoperative children with congenital heart disease

目的改良适用于先天性心脏病术后患儿的早期分级康复护理模式,为相关领域研究及临床实践提供参考依据。方法系统检索建库至2022年4月JBI、PubMed、Medline、CINAHL、中国知网、万方及维普数据库及相关网站中关于先天性心脏病患儿术后康复相关文献,结合质性访谈结果改良模式初稿;采用德尔菲法对6个省市16名专家进行2轮咨询,进一步论证改良先天性心脏病患儿术后早期分级康复护理模式的科学性和可行性。结果改良先天性心脏病患儿术后早期分级康复护理模式包含早期分级康复护理模式的评估、早期康复护理模式的分级标准、早期分级康复护理模式的实施、效果评价及健康教育4个一级条目、15个二级条目、48个三级条目。2轮咨询专家积极系数均为100%,专家权威系数分别为0.82、0.84,各级条目Kendall协调系数分别为0.188~0.246、0.223~0.287(均P<0.05)。结论改良先天性心脏病患儿术后早期分级康复护理模式具有科学性、针对性、安全性,可为先天性心脏病术后患儿的临床康复护理实践提供指导。

Objective To improve the early graded rehabilitation nursing model suitable for postoperative children with congenital heart disease,providing reference for related research and clinical practice.Methods Searched databases like JBI,PubMed,Medline,CINAHL,CNKI,Wanfang Data and related websites for information on postoperative rehabilitation of children with congenital heart disease.We improved the first draft model with qualitative interview results and used Delphi method to conduct two rounds of consultation for 16 experts from 6 provinces and cities to further test the scientific and feasibility of the model.Results The early graded rehabilitation nursing model for postoperative children with congenital heart disease includes 4 first-level items,15 second-level items and 48 third-level items.The 4 first-level items are the evaluation of the early graded rehabilitation nursing model,the grading standard of the early graded rehabilitation nursing model,the implementation of the early graded rehabilitation nursing model,the effect evaluation and health education.Experts'response rates were 100% in the 2 rounds,experts'authority coefficient were 0.82 and 0.84 respectively,and the Kendall's W rank-order correlation coefficients of all levels of indicators were 0.188-0.246,0.223-0.287(all P<0.01).Conclusions The improved early graded rehabilitation nursing model for postoperative children with congenital heart disease is scientific,pertinence and safe,which can provide guidance for clinical rehabilitation nursing practice.