基于改良德尔菲法构建《早中期结直肠癌根治术后中西医结合心理康复干预指南》临床问题OA北大核心CSTPCD
Defining Clinical Queries in Guidelines for Psychological Rehabilitation Intervention Combined Integrative Medicine after Radical Surgery for Early and Middle Stage Colorectal Cancer Based on Modified Delphi Method
目的 构建《早中期结直肠癌根治术后中西医结合心理康复干预指南》临床问题,为指南编写提供依据.方法 在文献研究、专家访谈基础上拟定临床问题清单,基于改良德尔菲法,发放三轮调查问卷.采用SPSS 26.0软件统计分析问卷结果,以积极系数、均值、满分频率、变异系数、格朗巴赫α系数为质量控制评价标准.结果 第一轮问卷共115名专家、医护人员、患者参与,积极系数98.29％,格朗巴赫α系数为0.925.15名专家参与第二、三轮问卷及讨论会,积极系数均为100.00％,格朗巴赫α系数分别为0.916、0.925.最终纳入12项临床问题(PICO结构问题)及20项指南重要内容(非PICO结构问题).临床问题涵盖患者中医特征、中西医干预方式适用范围、中医干预方式(包括针灸、推拿按摩、情志护理、汤药、四诊的医患互动、康复运动等)、介入时机及时长(包括围手术期及术后)及人群(包括患者及其照护者).结论 通过改良德尔菲法进行本指南临床问题筛选研究,为指南编写提供了依据,提示医护患共同参与、多领域专家共识会、非PICO结构化问题有效转化在相关中西医结合肿瘤心理康复指南首次编制具有重要意义.
Objective To identify the clinical queries for the"Guidelines for Psychological Rehabilitation Intervention Combined Integrated Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer",and to provide a basis for the compilation of guidelines.Methods A preliminary draft was formulated based on literature review and expert interviews.Then opinions were collected with three rounds of questionnaires using a modified Delphi method to obtain the current version of clinical queries for the guideline.The SPSS 26.0 software was employed in statistical analysis of the results,including positivity coefficient,mean,full score ratio,coefficient of variation,and Cronbach's α for quality control.Results A total of 115 experts,healthcare professionals,and patients participated in questionnaire Round 1(positivity coefficient:98.29％,Cronbach's α:0.925).Fifteen experts participated in questionnaire Round 2-3 and discussion session(positivity coefficient:100.00％,Cronbach's α:0.916 and 0.925,respectively).Ultimately,12 clinical queries(PICO)and 20 important items(non-PICO)for the guidelines were included,covering individual characteristics relate to Chinese medicine(CM),the scope of integrative medicinal interventions,CM intervention methods(acupuncture,massage,emotional care,decoction,doctor-patient interactions in consultations,rehabilitation exercises,etc.),the timing and duration of CM intervention(the perioperative and postoperative periods)and concerned population(the patient and his/her caregivers).Conclusions The study on the screening of clinical queries in this guideline through the modified Delphi method provides a basis for the modulating of the guidelines,suggesting that the joint participation of doctors,nurses and patients,the consensus meeting of experts in multiple fields,and the effective transformation of non-PICO structured queries are of great significance in the first compilation of relevant guidelines for cancer psychological rehabilitation with integrative medicine.
彭蓉晏;杨宇飞;孙凌云;刘稼玺;庞英;王子旭;唐末;丁亚丛;梁昌昊;唐丽丽
北京中医药大学研究生院(北京 100029)||中国中医科学院西苑医院肿瘤科(北京 100091)中国中医科学院西苑医院肿瘤科(北京 100091)北京肿瘤医院康复科(北京 100142)中国中医科学院中医临床基础医学研究所(北京 100700)北京中医药大学循证医学中心(北京 100029)
指南临床问题构建心理干预中医学中西医结合肿瘤康复结直肠癌
guidelinesclinical queries constructionpsychological interventionChinese medicineintegrative medicinecancer survivorship carecolorectal cancer
《中国中西医结合杂志》 2024 (008)
912-920 / 9
中国中医科学院西苑医院名老中医经验传承研究专项(No.XYZX0101-30);国家中医药管理局中医药传承与创新"百千万"人才工程(No.020450004);国家中医药管理局2019年重大疑难疾病中西医临床协作能力建设项目(No.070030003);中国中医科学院西苑医院学术经验继承项目(No.PYJMPSC202412)
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