基于最佳证据构建腹膜透析患者照护管理方案

Construction of a caring management program for peritoneal dialysis patients based on best evidences

目的构建腹膜透析患者照护管理方案,为医护人员对腹膜透析患者进行照护管理提供理论参考。方法系统检索国内外证据,以最佳证据总结为指导,构建腹膜透析患者照护管理方案初稿。2022年9─10月采用德尔菲法(专家咨询法)对34名专家进行函询,收集专家意见并修订,形成方案终稿。结果2轮专家函询问卷的有效回收率分别为89.47%和97.06%,专家的权威系数分别为0.936和0.942,第2轮函询中,一、二级条目专家意见协调系数分别为0.248和0.145(P<0.001)。最终确立腹膜透析患者照护管理方案包含7个一级指标,48个二级指标。结论为进一步提高腹膜透析患者居家治疗有效性,改善患者生活质量,采用德尔菲法构建了腹膜透析患者照护管理方案,可为医护人员临床实践提供参考。其可实施性和临床效益有待进一步验证。

Objective To construct a caring management program for peritoneal dialysis(PD)patients,and to provide theoretical reference for medical staff to conduct long-term caring management for PD patients.Methods The caring management program for PD patients was first drafted based on the systematic retrieval of domestic and foreign evidences and guided by the best evidences of the management for PD patients.Thirty-four experts were then consulted by Delphi method to obtain their advices and clinical experiences.The caring management program was finally constructed between September to October 2022.Results In the two rounds of consultation by mails,the effective response rates were 89.47% and 97.06%,and the authority coefficients of experts were 0.936 and 0.942.In the second round of consultation by mails,the coordination coefficients of experts to the first and second levels of indicators were 0.248 and 0.145,respectively(P<0.001).The caring management program for PD patients consisted of 7 first level indicators and 48 second level indicators.Conclusion To further improve the effectiveness of treatment at home and the quality of life of PD patients,we have constructed a care management program for PD patients using the Delphi method.This program can serve as a reference of clinical guidance for medical staff.However,the practical value and clinical benefits of the program need to be further verified.