基于德尔菲专家法构建观察等待期良性前列腺增生患者下尿路症状的干预方案

Based on the Delphi expert method to construct an intervention plan for BPH/LUTS during the observation and waiting period

目的探讨基于德尔菲专家法构建观察等待期良性前列腺增生(BPH)患者下尿路症状(LUTS)的干预方案的可行性。方法通过检索文献、质性访谈、8名相关领域专家进行2轮德尔菲法咨询构建形成干预方案,对2021年5月1日至2021年6月1日在大庆市人民医院随机招募10例≥50岁的BPH患者实施预实验来验证干预方案的可行性。结果2轮德尔菲专家法咨询问卷回收率为100%(8/8),第一轮与第二轮的专家权威系数(Cr)分别为0.8438和0.9589,肯德尔协调系数(Kendall'sW)分别为0.216(Х^(2)=63.918,P<0.01)和0.280(Х^(2)=42.567,P<0.001);第一轮专家协调程度优于第二轮。第1轮咨询38个条目,各条目重要性评分均数为3.00~4.75分,变异系数0.10~0.35分,第2轮咨询20个条目,各条目重要性评分均数为3.50~4.75分,变异系数为0.10~0.31分,经咨询后形成3个维度,18个条目。最终形成观察等待期BPH患者LUTS的干预方案。干预后的国际前列腺症状评分(IPSS)低于干预前,差异无统计学意义(P>0.05);干预后的日间、夜间排尿次数少于干预前,差异均有统计学意义(均P<0.05)。结论基于德尔菲专家咨询法构建观察等待期BPH患者LUTS的干预方案具有实用性,但需延长干预时间对临床与生活应用的科学性进行验证。

Objective Based on the Delphi expert method to construct an intervention scheme for lower urinary tract symptoms(LUTS)in patients with benign prostate hyperplasia(BPH)during the observation waiting period.Methods The intervention protocol,formed by searching the literature,qualitative interviews,and 2 rounds of Delphi method consultation with 8 experts in related fields,was randomly recruited in the Daqing People's Hospital from May 1,2021 to June 1,2021 for 10 BPH patients≥50 years of age,and a pre-trial was implemented to validate the feasibility of the intervention protocol.Results The return rate of the Delphi expert consultation questionnaires for the 2 rounds was 100%(8/8),and expert authority coefficient(Cr)for the first and second rounds was 0.8438 and 0.9589,with Kendall's W concordance coefficients of 0.216(Х^(2)=63.918,P<0.01)and 0.280(Х^(2)=42.567,P<0.001).The coordination of experts in the first round was better than that in the second round.There were 38 items in the first round of consultation.The average importance score of each item was 3.00-4.75 scores,and the coefficient of variation was 0.10-0.35 scores.There were 20 items in the second round of consultation.The average importance score of each item was 3.50-4.75 scores,and the coefficient of variation was 0.10-0.31 scores.After consultation,18 items were formed in 3 dimensions.Finally,an intervention plan for LUTS in BPH patients during the observation waiting period was developed.The the international prostate symptom score(IPSS)was lower after the intervention than before the intervention,with no statistically significant difference(P>0.05),and the number of daytime and nighttime urination was less than that before the intervention,with a statistically significant difference(all P<0.05).Conclusions The utility of constructing an intervention programme for observing LUTS in BPH patients during the waiting period based on the Delphi expert consultation method,but the scientific validation of the clinical and life application needs to be validated by extending the intervention time.