护理学报2025，Vol.32Issue(21)：11-17,7.DOI:10.16460/j.issn2097-6569.2025.21.011
基于COM-B模型脑卒中患者吞咽功能促进方案的构建
Construction of COM-B model-based swallowing function improvement program for stroke patients
摘要
Abstract
Objective To develop a swallowing function improvement program for stroke patients taking COM-B model as theoreti-cal framework,and to provide an evidence-based foundation for standardized rehabilitation management of dysphagia in this popu-lation.Methods We followed the"6S"evidence pyramid to conduct a systematic search for domestic and international literature.Through multidisciplinary team discussion,the initial program was drafted and structured based on the COM-B model,which included three core dimensions—Capability,Opportunity,and Motivation—and was further detailed into 14 secondary dimensions and 34 specific intervention items.Delphi method was used to conduct two rounds of consultation with 15 experts in neurology,rehabilitation,nursing,and nutrition.The final version of the program was refined based on expert feedback.Results The response rate of the two rounds of consultation was 100%.The authority coefficients of the experts were 0.940 and 0.967,and Kendall's W coefficients 0.163 and 0.145(both P<0.001),respectively.The program has garnered high recognition from experts for its scientific foundation,structural coherence,and operational feasibility,and it encompassed multidimensional interventions,including physiological rehabilitation train-ing,environmental and resource optimization,establishment of social support networks,and enhancement of psychological motivation.Conclusion The COM-B model-based swallowing function improvement program for stroke patients developed in this study is fea-tured by its scientific rigor and coherent structure.It demonstrates strong clinical applicability and potential for widespread application,providing reference for systematic and standardized nursing care of dysphagia in stroke patients.关键词
COM-B模型/脑卒中/吞咽障碍/循证护理/德尔菲法Key words
COM-B model/stroke/dysphagia/evidence-based nursing/Delphi method分类
医药卫生引用本文复制引用
陈梅,黄庆萍,吴玉娥,高莹,张淑清,王敬琴,张建荣..基于COM-B模型脑卒中患者吞咽功能促进方案的构建[J].护理学报,2025,32(21):11-17,7.基金项目
东莞市社会发展科技重点项目(20211800904942) （20211800904942）
广东省医学科研基金(A2025052) （A2025052）
