基于GRACE风险评分模型的NSTE-ACS患者分级护理方案的构建

Construction of graded nursing plan for NSTE-ACS patients based on GRACE risk score model

目的基于全球急性冠状动脉事件登记(GRACE)风险评分模型构建非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者分级护理方案,为临床NSTE-ACS患者护理提供依据。方法检索2013年1月1日至2018年9月30日PubMed、万方医学网、中国知网、维普资讯中文期刊服务平台等数据库中有关NSTE-ACS分级护理的文献。对相关文献进行详细分析,并召集专家开展小组讨论,构建NSTE-ACS患者分级护理草案。运用德尔菲法对专家进行2轮函询,根据专家函询结果对项目进行筛选,最终确定NSTE-ACS患者分级护理方案。结果函询了15名专家,第1轮有效回复率为100.00%,第2轮有效问卷14份,有效回收率为93.33%。2轮函询后各条目的变异系数为0.12~0.25,肯德尔和谐系数为0.265,差异有统计学意义(P<0.05),重要性赋值为4.11~5.00分,最终形成基于GRACE风险评分模型的分级护理方案,包括3个一级指标,21个二级指标。结论构建的NSTE-ACS患者分级护理方案科学、可靠,可为临床实践提供指导。

Objective To construct a graded nursing plan for non-ST-segment elevation acute coronary syndrome(NSTE-ACS)patients based on the global registry of acute comnary events(GRACE)risk score model,and to provide basis for clinical nursing of NSTE-ACS patients.Methods The literatures about NSTE-ACS graded nursing in PubMed,Wanfang Medical Network,CNKI and VIP were retrieved from January 1,2013 to September 30,2018.The related literatures were analyzed in detail,and experts were called to hold group discussions to construct the draft of graded nursing for the NSTE-ACS patients.Delphi method was used to conduct two rounds of consultation with experts,and the items were screened according to the results of expert consultation,and finally the graded nursing plan for the NSTE-ACS patients was determined.Results Fifteen experts were consulted,and the effective response rate was 100.00%in the first round and 14 valid questionnaires in the second round,with an effective recovery rate of 93.33%.After two rounds of consultation,the coefficient of variation for each item was 0.12-0.25,the Kendall harmony coefficient was 0.265,and the difference was statistically significant(P<0.05).The mean importance score was 4.11-5.00.Finally,a graded nursing plan based on GRACE risk score model was formed,including three primary indicators and 21 secondary indicators.Conclusion The grading nursing plan for NSTE-ACS patients formed in this study is scientific and reliable,and can provide guidance for clinical practice.