中度和重度痴呆患者照护技术方案的构建

Developing dementia care technology program for patients with moderate to severe dementia

目的 :构建中度和重度痴呆患者照护技术方案,为痴呆患者照护提供实践指引。方法 :共35名专家参与了两轮德尔菲法专家咨询,对基于文献调研以及服务实践现状编制的中度和重度痴呆患者照护技术方案初稿的内容框架和照护技术内容进行重要性评价,并提供具体修改和补充建议。结果 :两轮专家咨询问卷回收率均为91.43%,权威系数分别为0.906和0.942,协调系数分别为0.096和0.065。最终确定个体化心理社会支持、药物管理、教育、年龄相关躯体疾病管理以及生活环境安排5个一级指标,重要性赋值均数为4.41~4.75,变异系数为0.093~0.181,含89项技术内容,重要性赋值均数为3.84~4.88,变异系数为0.070~0.259。其中,针对中度痴呆患者的照护技术内容37项,针对其照护者39项;在中度痴呆患者照护技术方案的基础上,增加了针对重度痴呆患者的照护技术内容4项,针对其照护者9项。结论 :方案涵盖5个照护核心要素,专家意见协调且集中,方案各项条目具有较好的重要性评价等级,可为中度和重度痴呆患者的优质照护实践提供科学指引。

Objective:To develope the care technology program for patients with moderate to severe dementia,and to offer practical guidance for dementia care.Methods:A total of 35 experts were involved in two rounds of expert consultation using the Delphi method.The first draft of the care technology program which was developed based on literature review and service practice,was assessed for importance,and experts provided specific modifications and supplementary suggestions.Results:The response rates for the two rounds of expert consultation were both 91.43%,authoritative coefficients were 0.906 and 0.942,coordination coefficients were 0.096 and 0.065,respectively.Following the two rounds of expert consultation,five care elements,including personalized psychosocial support,drug management,education,age-related physical disease management,and living environment arrangement,were determined as primary indicators.These elements received a mean importance assignment of 4.41-4.75,with a coefficient of variation of 0.093-0.181.Additionally,there were 89 subordinating technical content with a mean importance assignment of 3.84-4.88 and a coefficient of variation of 0.070-0.259.Specifically,there were 37 care technologies for patients with moderate dementia and 39 care technologies for their caregivers.For severe dementia patients,there were 4 additive items,and 9 additive items for their caregivers.Conclusion:The care technology program covers five core care elements,can provide scientific guidance for high-quality care practice for patients with moderate to severe dementia.The expert opinions are coordinated and centralized,and each item of the program has been evaluated to have a good level of importance.