未破裂颅内动脉瘤介入治疗患者自我管理干预方案的构建

Construction of a self-management intervention program for undergoing interventional therapy due to unruptured intracranial aneurysm

目的构建未破裂颅内动脉瘤介入治疗患者自我管理干预方案,为患者自我管理支持提供参考依据。方法依据循证方法系统检索相关文献,提取及整合最佳证据,并以赋能理论框架为指导拟订未破裂颅内动脉瘤介入治疗患者的自我管理干预方案初稿;采用德尔菲法进行2轮专家函询,并评价专家的权威程度和专家意见协调程度(由肯德尔和谐系数和变异系数表示),经研究小组讨论后对方案内容进行修订成稿。结果本研究经文献回顾,最终纳入13篇文献,共15名专家参与两轮专家函询,其问卷的回收率分别为93.75%(15/16)和100%(15/15);专家的权威程度分别为0.92和0.94;条目的肯德尔和谐系数分别为0.30和0.23(P<0.001),各条目变异系数均<0.25。通过两轮专家函询,最终形成干预方案的终稿,包括5个一级条目、15个二级条目和42个三级条目。结论未破裂颅内动脉瘤介入治疗患者自我管理干预方案具有较好的科学性、适用性和可行性,能够为患者的自我管理干预提供指引。

Objective To construct a self-management intervention scheme for unruptured intracranial aneurysm interventional therapy,and provide references for clinical self-management intervention support.Methods According to the evidence-based method,the literature was systematically searched,and the best evidence was extracted and integrated.The first draft of a self-management intervention plan for patients with unruptured intracranial aneurysm was prepared with the guidance of the empowerment theory framework.Delphi method was used to conduct two rounds of expert correspondence consultation.The authority coefficient of experts and the degree of coordination of expert opinions(Kendall's W values and coefficient of variation)were evaluated,and the content of the program was revised after discussion by the research group.Results Following a literature review,this study comprised 13 papers.The two rounds of expert letter consultation involved 15 experts totally,and the recovery rates were 100%(15/15)and 93.75%(15/16),respectively.Within the two expert rounds,the authority coefficients were 0.92 and 0.94,and the corresponding Kendall's W values were 0.30 and 0.23(P<0.001).Besides,the coefficient of variation of each item was less than 0.25.After two rounds of expert consultation,the final draft of the intervention scheme was formed,including 5 first-level items,15 second-level items,and 42 third-level items.Conclusion The self-management intervention program for unruptured intracranial aneurysm interventional therapy has good scientific,applicability,and feasibility,and can provide intervention guidance for patients'self-management practice.