宫颈癌术后患者随访清单的制订及应用

Development and application of a follow-up checklist for postoperative patients with cervical cancer

目的制订科学、规范的宫颈癌术后患者随访清单,为随访工作提供科学的工具支持。方法基于患者需求,通过文献回顾、半结构式访谈及小组讨论制订宫颈癌术后患者随访清单初稿;于2022年10月—12月采用德尔菲法对专家进行2轮函询,筛选专家意见并修改完善清单,形成随访清单终稿。采用便利抽样法,于2023年2月—3月选取辽宁省某三级甲等医院的8名护士和15例宫颈癌术后患者作为研究对象,由护士采用术后随访清单对患者进行电话随访,对制订的随访清单进行评价。结果2轮函询专家的积极系数分别为88.89%和100%;专家权威系数分别为0.88、0.89。第1轮专家函询一、二、三级指标的肯德尔和谐系数分别为0.177、0.245、0.179;第2轮分别为0.170、0.118、0.107(P<0.05)。最终形成的宫颈癌术后患者随访清单包括生理与日常生活支持、信息支持、心理支持和社会支持4项一级指标、12项二级指标及45项三级指标。护患双方均认为随访清单内容全面,具有较强的专业性和临床实用性。结论宫颈癌术后患者随访清单结构合理,内容较全面,且具有可靠性、专科性和实用性,可为宫颈癌术后患者出院后的随访提供科学、规范的工具支持。

Objective To formulate a scientific and standardized follow-up checklist for postoperative patients with cervical cancer,and provide a scientific tool to support the follow-up work.Methods The first draft of the follow-up checklist was constructed through literature review and semi-structured interviews,and the final draft of the follow-up checklist was formed by conducting 2 rounds of correspondence with experts using the Delphi method from October to December 2022,screening experts’opinions and revising and improving the checklist.The convenience sampling method was adopted to select 8 nurses and 15 patients with cervical cancer after surgery from a tertiary A hospital in Liaoning Province from February to March 2023 as the research subjects.The nurses made telephone follow-up visits to the patients with the postoperative follow-up list and evaluated the follow-up list.Results The positive coefficients of the experts in the 2 rounds of correspondence were 88.89%and 100%,respectively;the authoritative coefficients were 0.88 and 0.89,respectively;the Kendal harmony coefficient of the primary,secondary and tertiary indicators were 0.177,0.245 and 0.179 in the first round and 0.170,0.118 and 0.107 in the second round,respectively(P<0.05).The final follow-up checklist for postoperative patients with cervical cancer included 4 primary indicators of physical and daily life support,information support,psychological support,and social support,12 secondary indicators,and 45 tertiary indicators.Both nurses and patients believed that the follow-up list was comprehensive with strong professional and clinical practicability.Conclusion The follow-up checklist is reasonable in structure,comprehensive in content,and reliable,specialized and practical,which can provide a scientific and standardized tool to support post-discharge follow-up of patients with cervical cancer.