基于Donabedian三维质量理论构建嵌合抗原受体T细胞治疗恶性血液病护理质量评价指标体系的研究

Research on the construction of a nursing quality evaluation index system for CAR-T therapy for hematologic malignancies based on Donabedian's three-dimensional quality theory

目的构建嵌合抗原受体T细胞治疗恶性血液病患者护理质量评价指标体系,为临床系统且科学地管理护理工作及评价其护理质量提供可靠依据。方法以Donabedian三维质量理论模式为框架,通过文献法、访谈法及专家论证法制定评价指标体系初稿,采用Delphi专家函询法及层次分析法确定各指标及权重。结果两轮Delphi专家函询的有效回收率分别为96.15%和100%,专家权威系数为0.862和0.901,Kendall's和谐系数为0.345和0.201。最终确立一个包含3个一级指标、12个二级指标及54个三级指标的嵌合抗原受体T细胞治疗恶性血液病患者护理质量评价指标体系。结论基于多种研究方法构建的嵌合抗原受体T细胞治疗恶性血液病护理质量评价指标体系具有科学性及可靠性,能较为全面地衡量嵌合抗原受体T细胞治疗恶性血液病护理质量,为评价、改善其护理质量提供依据。

Objective To construct a nursing quality evaluation index system for patients with malignant blood diseases treated with chimeric antigen receptor T cell(CAR-T),so as to provide a reliable basis for clinical systematic and scientific management of nursing work and evaluation of nursing quality.Methods Based on Donabedian's three-dimensional quality theory model as the framework,the first draft of the evaluation index system was formulated through literature review,interview and expert demonstration.Delphi expert letter consultation and analytic hierarchy process were used to determine the index and weight.Results The effective recovery rates of the two rounds of Delphi expert consultation were 96.15%and 100%,the expert authority coefficients were 0.862 and 0.901,and the Kendall's harmony coefficients were 0.345 and 0.201.Finally,a nursing quality evaluation index system for patients with malignant blood diseases treated with CAR-T was established,including 3 first-level indicators,12 second-level indicators and 54 third-level indicators.Conclusion The evaluation index system for nursing quality of CAR-T cell therapy for malignant blood diseases based on a variety of research methods is scientific and reliable,which can comprehensively measure the nursing quality of CAR-T cell therapy for malignant blood diseases,and provide a basis for evaluating and improving the quality of nursing.