老年髋部骨折患者术后出院准备度评估指标的构建

Construction of discharge readiness assessment index for elderly patients after hip fracture surgery

目的:构建适用于我国老年髋部骨折患者术后的出院准备度评估指标,为老年髋部骨折患者实施出院准备服务提供依据。方法:于2018年1月—2023年3月通过文献检索及半结构访谈构建初版的老年髋部骨折患者出院准备度评估指标。于2023年4—5月采用德尔菲法选择19名来自医疗、护理领域的专家对各级指标进行2轮专家函询,通过指标筛选与修改构建老年髋部骨折患者出院准备评估指标的最终版本。结果:文献检索及阅读获得13篇文献。2轮专家函询共收集专家意见101条,2轮函询专家参与率及问卷回收率均为100.00%(19/19);2轮专家咨询的判断系数及熟悉程度系数分别为0.979、0.832,专家权威系数均为0.905;2轮专家函询的肯德尔和谐系数分别为0.154、0.157(P<0.01)。最终构建的老年髋部骨折患者出院准备度评估指标包含3项一级指标、12项二级指标。结论:本研究构建的老年髋部骨折患者术后出院准备度评估指标具有科学性及可靠性,可以为精准评估老年髋部骨折患者术后的出院准备情况提供依据。

Objective To construct an evaluation index of discharge readiness suitable for elderly patients after hip fracture surgery in China,so as to provide a basis for the implementation of discharge readiness services for elderly patients after hip fracture surgery.Methods From January 2018 to March 2023,a preliminary version of the discharge readiness evaluation indicators for elderly patients with hip fracture was constructed through literature search and semi-structured interviews.From April to May 2023,the Delphi method was used to select 19 experts from the medical and nursing fields to conduct two rounds of expert inquiries on various indicators.The final version of the discharge preparation evaluation indicators for elderly hip fracture patients was constructed through indicator screening and modification.Results Through literature search and reading,13 literatures were obtained.A total of 101 expert opinions were collected in two rounds of expert consultation,and the participation rate and questionnaire recovery rate of the two rounds of expert consultation were 100.00%(19/19).The judgment coefficient and familiarity coefficient of the two rounds of expert consultation were 0.979 and 0.832,respectively,and the expert authority coefficient were both 0.905.The Kendall's harmony coefficients of the two rounds of expert correspondence were 0.154 and 0.157,respectively(P<0.01).The final evaluation index of discharge readiness of elderly patients with hip fracture included three primary indexes and 12 secondary indexes.Conclusions The evaluation index of discharge readiness of elderly patients after hip fracture surgery established in this study is scientific and reliable,providing a basis for accurately assessing discharge readiness of elderly patients after hip fracture surgery.