宫颈癌患者快速康复护理质量敏感性指标构建OACSTPCD
Construction of nursing sensitive quality indicators for enhanced recovery after surgery in cervical cancer patients
目的 构建宫颈癌患者快速康复护理质量敏感性指标,为宫颈癌患者围术期护理质量评价提供参考依据.方法 以结构-过程-结果模型为指导框架,2023年2-4月选取南方医科大学南方医院的12名妇科护理人员与7名宫颈癌患者进行一对一半结构式访谈,结合循证方法、德尔菲法及层次分析法,构建宫颈癌患者快速康复护理敏感性质量指标,并确定指标权重.结果 2轮函询问卷的有效回收率分别为88%、100%,专家权威系数分别为0.824、0.833.2轮专家函询中,各条目得分平均值范围为3.61～4.87分、4.43～4.96分,满分率分别为26.4%～87.0%、52.2%～95.7%,专家意见集中程度较高;2轮专家函询的Kendall's W分别为0.101(P<0.05)、0.159(P<0.05).2轮专家函询结束后形成的宫颈癌患者快速康复护理敏感性质量指标包含一级指标3个、二级指标8个、三级指标42个.一级指标权重:结构占0.335、过程占0.341、结果占0.324;二级指标组合权重:人力资源占0.169、单元设施与制度占0.169、预康复管理占0.084、术前快速康复占0.084、术中快速康复占0.086、术后快速康复占0.087、护理结局占0.163、满意度占0.158.结论 研究形成的宫颈癌快速康复护理质量敏感性指标科学、可靠,具有较强的专科性,可用于宫颈癌围术期护理质量评估与持续改进.
Objective To construct nursing sensitive quality indicators for enhanced recovery after surgery in cervical cancer patients,providing a reference for the evaluation of perioperative nursing quality in these patients.Methods Guided by the structure-process-outcome model,from February to April 2023,12 gynecological nursing staff and 7 cervical cancer patients from Southern Hospital,Southern Medical University were selected for one-on-one semi-structured interviews.Combined with evidence-based methods,the Delphi method,and the analytic hierarchy process,sensitive quality indicators for en-hanced recovery after surgery in cervical cancer patients were constructed,and the weights of the indicators were deter-mined.Results The effective recovery rates of the two rounds of questionnaires were 88%and 100%,and the expert au-thority coefficients were 0.824 and 0.833,respectively.In the two rounds of expert consultations,the average scores of each item ranged from 3.61 to 4.87 and 4.43 to 4.96,and the rates of full marks were 26.4%to 87.0%and 52.2%to 95.7%,respectively.The expert opinions were relatively concentrated.The Kendall's W coefficients of the two rounds of expert consultations were 0.101(P<0.05)and 0.159(P<0.05),respectively.After the two rounds of expert consulta-tions,sensitive quality indicators for rapid recovery nursing in cervical cancer patients were formed,including 3 primary in-dicators,8 secondary indicators,and 42 tertiary indicators.The weights of the primary indicators were:structure 0.335,process 0.341,and outcome 0.324.The combined weights of the secondary indicators were:human resources(0.169),u-nit facilities and systems(0.169),pre-rehabilitation management(0.084),preoperative enhanced recovery(0.084),intrao-perative enhanced recovery(0.086),postoperative enhanced recovery(0.087),nursing outcomes(0.163),and degree of satisfaction(0.158).Conclusion The constructed nursing sensitive quality indicators for enhanced recovery aftre surgery in cervical cancer patients are scientific,reliable,and highly specialized,which can be used for the evaluation and continuous improvement of perioperative nursing quality in these patients.
罗艳霞;叶敏珊;陈怡藤;王馨笛;李曦;阮伟清
南方医科大学南方医院惠侨医疗中心,广州 510515||南方医科大学护理学院,广州 510515南方医科大学南方医院惠侨医疗中心,广州 510515||南方医科大学护理学院,广州 510515南方医科大学南方医院惠侨医疗中心,广州 510515||南方医科大学护理学院,广州 510515南方医科大学南方医院惠侨医疗中心,广州 510515||南方医科大学护理学院,广州 510515南方医科大学南方医院惠侨医疗中心,广州 510515||南方医科大学护理学院,广州 510515南方医科大学南方医院惠侨医疗中心,广州 510515
临床医学
宫颈癌快速康复德尔菲法结构-过程-结果模型护理质量指标
Cervical cancerEnhanced recoveryDelphi methodStructure-process-outcome modelNursing quality indica-tors
《保健医学研究与实践》 2024 (1)
1-6,6
广东省科技计划项目(2022A1414020007).
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