基于知信行理论的晚期癌症照顾者“4M”死亡教育干预方案的构建

Construction of a“4M”death education intervention program for advanced cancer caregivers based on the theory of knowledge,belief and practice

目的构建晚期癌症照顾者的死亡教育干预方案, 为对晚期癌症照顾者进行死亡教育提供参考。方法采用文献分析法、半结构式访谈法、德尔菲专家咨询法, 基于知信行理论初步拟定死亡教育干预方案。于2022年4-5月遴选15名来自安宁疗护、生死教育、肿瘤护理、肿瘤心理护理等相关领域的专家对上述的方案进行2轮专家函询, 并通过预试验修订和完善方案内容。结果 2轮专家函询后专家意见趋于一致, 专家权威性系数为0.87, 2轮函询内容的可行性、有效性及科学性Kendall协调系数分别为0.181、0.303、0.363和0.249、0.355、0.366(均P<0.05)。预试验修订和完善了干预频次和内容, 最后形成晚期癌症照顾者死亡教育干预方案, 内容包括4个阶段渐进式死亡教育主题, 即遇见死亡、谈论死亡、拥抱死亡和超越死亡。结论本研究构建晚期癌症照顾者死亡教育干预方案内容具有可行性、有效性和科学性, 可为今后在安宁疗护中开展死亡教育提供借鉴。

Objective To construct a death education intervention program for advanced cancer caregivers to improve the reference for death education for advanced cancer caregivers.Methods Content analysis,semi-structured interview,Delphi expert consultation method were used to develop a preliminary death education program based on the theory of knowledge,belief,and behavior.From April to May 2022,fteen experts from palliative care,life and death education,oncology nursing,psychological nursing and other related fields were selected for two rounds of expert consultation,and the contents of the program were revised and improved through preliminary experiments.Results After two rounds of expert consultation,the results showed that the expert opinions tend to be unanimous.The authoritative coefficient of experts was O.87,and the Kendall coordination coefficients of feasibility,validity and scientificity of the two rounds of consultation were 0.181,0.303,0.363 and 0.249,0.355,0.366,respectively(both P<0.05).The preliminary experiments revised and improved the intervention frequency and content,and finally formed a death education intervention program for advanced cancer caregivers which included four-stage progressive death themes:made an appointment with death,made a discussion on death,made an embrace with death and made friends with death.Conclusions T The process of constructing a death education program for advanced cancer caregivers is scientific,and the content is feasible,valid,and scientific.In addition,it is of great significance to promote death education in palliative care.