癌症患者濒死期支持性照护策略清单的构建

Construction of supportive care strategies checklist for cancer patients in the dying period/

目的:构建癌症患者濒死期支持性照护策略清单,为临床护士实施濒死期护理提供实践指引。方法:依据支持性照护框架,在充分回顾濒死期癌症患者照护相关文献的基础上构建癌症患者濒死期支持性照护策略清单初稿,采用德尔菲法于2022年5月—8月对19名专家进行函询,依据专家对指标的评分以及提出的意见对清单进行修改和完善。结果:共开展2轮专家函询。最终确立的癌症患者濒死期支持性照护策略清单包括一级指标5个、二级指标30个。2轮函询的专家积极系数均为100%;专家的判断依据系数为0.94,熟悉程度系数为0.86,权威系数为0.90;2轮函询专家评分的变异系数分别为0~0.206和0~0.222,肯德尔和谐系数分别为0.116(P<0.001)和0.075(P=0.052)。结论:癌症患者濒死期支持性照护策略清单具有可靠性和临床实用价值,可为临床护士对濒死期癌症患者实施照护提供科学、规范、便捷的实践指引。

Objective:To formulate supportive care strategies checklist for cancer patients in the dying period,in order to provide practice guide for clinical nurses to develop end of life care.Methods:Guided by the Supportive Care Framework for cancer care,the supportive care strategies checklist was drafted through the literature review of the care of the dying cancer patients.We consulted 19 experts during May to August 2022 using the Delphi method,and further modified the checklist according to their scores and opinion on the indicators.Results:Two rounds of expert letter consultations were conducted.The final supportive care strategies checklist for cancer patients in the dying period consisted of 5 first-level indicators and 30 second-level indicators.The response rates of 2 rounds were both 100%;the judgment basis coefficient,familiarity coefficient and authority coefficient of expert consultation were 0.94,0.86,and 0.90 respectively;the variable coefficient for the 2 rounds of consultations were 0-0.206 and 0-0.222,and the Kendall's W coefficients of concordance were 0.116(P<0.001)and 0.075(P=0.052).Conclusion:The supportive care strategies checklist for cancer patients in the dying period is reliable and practical,which can provide practice guide for clinical nurses to conduct scientific,standardized and convenient care for the dying cancer patients.