声带器质性发声障碍患者围手术期嗓音康复审查指标的制定及障碍因素分析

Development of review indicators for perioperative voice rehabilitation in patients with organic vocal fold dysphonia and its obstacle factors

目的制定声带器质性发声障碍患者围手术期嗓音康复审查指标,分析障碍因素,为证据的临床转化提供依据。方法以知识转化模式(knowledge to action framework,KTA)为理论指导,按照知识应用步骤:确定问题,组建循证小组和专家团队;将知识引入临床情景,综合函询和讨论制定审查指标及审查方法;根据基线审查结果基于渥太华研究应用模型(Ottawa Model of Research Use,OMRU),经头脑风暴法分析证据引入临床的障碍因素。结果共纳入15条最佳证据,制定13条审查指标及其方法;归纳分析出3方面的8条障碍因素,即基于证据变革方面2条、潜在采纳者3条及实践环境3条。结论本研究审查指标制定具有科学性和内容可行性,障碍因素评估具有科学性和内容新颖性,研究方法有借鉴作用,研究内容为证据转化提供依据。

Objective To develop review indicators for perioperative voice rehabilitation in patients with vocal cord organic dysphonia,to analyze the obstacle factors,and to provide reference for the transformation of clinical evidence.Methods Guided by the knowledge to action framework(KTA)model,according to steps of knowledge application including identifying problems,establishing evidence-based groups and expert teams and introducing knowledge into clinical situation,review indicators and review methods were identified and formulated through consultation and discussion.According to the results of the baseline review,based on the OMRU model,the barriers to introducing evidence into clinical practice were analyzed by brainstorming method.Results A total of 15 pieces of best evidence were included,and 13 review indicators and review methods were identified and formulated.A total of 8 barriers including 2 in evidence reform,3 in potential adopter and 3 in practice environment were summarized.Conclusion The development of review indicators in this study is scientific and feasible,and the assessment of obstacles was scientific and novel.The research may provide reference for evidence transformation.