基于时机理论高龄产妇出院准备服务方案的构建

Establishment of timing theory-based discharge preparation service scheme for advanced maternal age

目的构建基于时机理论的高龄产妇出院准备服务方案,旨在为高龄产妇出院管理提供参考依据。方法以时机理论为指导,参考《高龄妇女妊娠前、妊娠期及分娩期管理专家共识(2019)》,结合高龄产妇临床护理特点及医院现有的出院管理模式,通过文献回顾及多次小组会议讨论,拟定高龄产妇出院准备服务方案初稿。2024年1—3月,采用德尔菲法对来自广州、江苏、安徽3个省份10所综合性三甲医院的18名专家进行了2轮函询,形成高龄产妇出院准备服务方案终稿。结果2轮函询专家的积极系数均为100%,专家权威系数均为0.875,肯德尔和谐系数分别为0.347、0.286(均P<0.001)。最终确立高龄产妇出院准备服务方案包括5个一级指标、15个二级指标、50个三级指标。结论本研究通过德尔菲法构建的基于时机理论的高龄产妇出院准备服务方案具有科学性、可靠性和可行性,可为临床高龄产妇出院准备服务提供参考。

Objective To establish the discharge preparation service scheme based on timing theory for advanced maternal age,so as to provide reference for discharge management of advanced maternal age.Methods Guided by the theory of“Timing It Right”,Referring to the Expert Consensus of Elderly Parturient Women’s Management before Pregnancy,Pregnancy and Childbirth(2019),the draft of the scheme was formed through literature review and many group discussions combined with the characteristics of the advanced maternal age in the actual clinical care and existing discharge management mode of hospital.Based on the draft of the scheme,the expert questionnaire was compiled.From January to March 2024,a total of 18 experts from 10 comprehensive grade A hospitals in Guangzhou,Jiangsu,Anhui provinces were selected to conduct two rounds of Delphi expert consultation.After that,the final edition of discharge preparation service scheme for advanced maternal age was formed.Results The enthusiasm of experts were all 100%in two rounds of consultation,with expert authority coefficient of 0.875,and the Kendall coordination coefficients were 0.347 and 0.286 respectively(P<0.001).The final scheme consisted of 5 first-level,15 second-level,and 50 third-level items.Conclusion The discharge preparation service scheme for advanced maternal age based on the timing theory is scientific,reliable and feasible,and it can provide reference for clinical discharge preparation service.