基于Delphi法的早产儿过渡期家庭参与式护理方案的构建及KANO评价
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摘要
目的构建科学、规范、人性化的早产儿过渡期家庭参与式护理方案,为提高早产儿护理水平和院外护理质量奠定基础。方法采用Delphi法对15名专家进行两轮问卷函询,制订早产儿过渡期家庭参与式护理方案,并对200例参与该方案的患儿父母进行基于KANO模型的问卷调查,分析方案各条目满意度-重要度矩阵分布。结果两轮函询问卷有效回收率均为100.00%;专家权威程度分别为0.798和0.800;一、二级指标各条目变异系数在0.072～0.196之间;构建的护理方案包括6项一级指标和36项二级指标。正反向问卷信度分析Cronbach'sα系数分别为0.916和0.954;满意度-重要度矩阵项目分布中,优势区8项,待改进区6项,次要改进区10项,维持区12项。结论构建的护理方案能够满足早产儿过渡期家庭参与式护理要求,提升早产儿护理质量,并为其院外护理奠定基础,值得临床应用和推广。
Objective To construct a scientific,standardized and humanized family participatory nursing scheme for premature infants in transitional period,so as to lay a solid foundation for improving the level of nursing care and the quality of out-of-hospital care for premature infants.Methods Totally,15 experts were questionnaire enquiries by used Delphi consultation method to formulated the family participatory nursing scheme for premature infants.During the implementation of the scheme,200 families of children participating in the program were investigated by questionnaire based on the KANO model,and the KANO attribute,importance and satisfaction degree of various programs were analyzed.Results The recovery rates of the two questionnaires were 100%,the degree of experts authority were 0.798 and 0.800,the coefficient of variation of items was between 0.072 and 0.196,and the family participatory nursing scheme for premature infants in transitional period was constructed including 6 primary items and 36 secondary items.The Cronbach's α coefficient for the reliability analysis of forward and reverse questionnaires was 0.916 and 0.954 respectively.In the satisfaction-importance matrix,there were 8 items in the dominant area,6 items in the improvement area,10 items in the secondary improvement area,and 12 items in the maintenance area.Conclusion The nursing scheme constructed method can meet the requirements of family participatory nursing in the transition period of premature infants,improve the quality of nursing for premature infants,and lay a good foundation for their out-of-hospital nursing,which is worthy of clinical application and promotion.
Objective To construct a scientific,standardized and humanized family participatory nursing scheme for premature infants in transitional period,so as to lay a solid foundation for improving the level of nursing care and the quality of out-of-hospital care for premature infants.Methods Totally,15 experts were questionnaire enquiries by used Delphi consultation method to formulated the family participatory nursing scheme for premature infants.During the implementation of the scheme,200 families of children participating in the program were investigated by questionnaire based on the KANO model,and the KANO attribute,importance and satisfaction degree of various programs were analyzed.Results The recovery rates of the two questionnaires were 100%,the degree of experts authority were 0.798 and 0.800,the coefficient of variation of items was between 0.072 and 0.196,and the family participatory nursing scheme for premature infants in transitional period was constructed including 6 primary items and 36 secondary items.The Cronbach's α coefficient for the reliability analysis of forward and reverse questionnaires was 0.916 and 0.954 respectively.In the satisfaction-importance matrix,there were 8 items in the dominant area,6 items in the improvement area,10 items in the secondary improvement area,and 12 items in the maintenance area.Conclusion The nursing scheme constructed method can meet the requirements of family participatory nursing in the transition period of premature infants,improve the quality of nursing for premature infants,and lay a good foundation for their out-of-hospital nursing,which is worthy of clinical application and promotion.
引文
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[12]李月仪,陈伟菊.德尔菲法在护理管理学中的应用现状[J].护理研究,2018,32(21):3339-3341. DOI:10.12102/j.issn.1009-6493.2018.21.006.
[13]李梁,杨楠,任红,等.德尔菲法构建临床护理人员人文关怀能力评价指标体系[J].护理研究,2016,30(27):3376-3379.DOI:10.3969/j.issn.1009-6493.2016.27.016.
[14]朱玲玲,韩瑜姣,毕越英.应用Delphi法构建三级甲等医院科室分类模型护理指标体系的研究[J].护理管理杂志,2015,15(3):159-161.
[15]张桃桃,黄正新,吴君,等.基于德尔菲法研制住院患者社会适应能力评估量表[J].护理学杂志,2014,29(13):65-67.DOI:10.3870/hlxzz.2014.13.065.
[16]EDMUNDS S, HAINES L, BLAIR M. Development of aquestionnaire to collect public health data for school en-trants in London:Child Health Assessment at School Entry(CHASE)project[J]. Child:Care,Health and Develop-ment,2005,31(1):89-97.
[17]宋婷婷,张秀英,张岚,等.新生儿重症监护室患儿家属焦虑状况研究进展[J].中国护理管理,2012,12(6):81-83.
[18]闵丽华,张小建,曹学华,等.以家庭为中心的产科服务模式对接受辅助生殖技术产妇的影响[J].护理管理杂志,2013,13(1):30-31.
[19]李娟,王庆红,吴红敏,等.2005年中国城市产科新生儿出生状况调查[J].中国当代儿科杂志,2012,14(1):7-10.
[20]陈洁琼,毛莹,江宇.综合护理干预对剖宫产产妇母婴分离成功母乳喂养的影响[J].医学理论与实践,2018,31(23):3625-3626.
[21]CHERYL L H,LINDA W,SUSAN A,等.以家庭为中心护理模式的探讨及安全管理[J].中国循证儿科杂志,2009,4(6):481-484.
[22]史丽荣,马颖,芦献丽,等.FCC优质护理理念在新生儿健康教育中的应用[J].护理研究, 2013, 27(1):254-255.
[23]占六娇,余胜春.对大别山地区出院后早产儿健康教育的探讨[J].中国保健营养,2013,1(1):186-187.
[24]AHLQVIST-BJORKROTH S,BOUKYDIS Z,AXELIN AM,et al. Close collaboration with parents intervention toimprove parents’ psychological well-being and child de-velopment:Description of the intervention and study proto-col[J].Behavioural Brain Research,2017,325:303-310.DOI:10.1016/j.bbr.2016.10.020.
[25]罗家国,邱庚香,潘莎莎.基于克伦巴赫信度分析的工科学生实践教学质量评价之改进[J].创新与创业教育,2015,6(2):140-143.
[26]朱惠,李德华,涂玉芹,等.Kano模型调查结果分析对改进门诊服务的指导意义[J].华西医学,2017,32(9):1446-1448.
[2]WHITE-TRAUT R C,RANKIN K M,YODER J C,et al.In-fluence of H-HOPE intervention for premature infants ongrowth,feeding progression and length of stay during initialhospitalization[J]. Journal of Perinatology:Official Journalof the California Perinatal Association, 2015, 35(8):636-641.DOI:10.1038/jp.2015.11.
[3]WHITE-TRAUT R,RANKIN KM,PHAM T,et al.Preterminfants'orally directed behaviors and behavioral state re-sponses to the integrated H-HOPE intervention[J].InfantBehavior and Development,2014,37(4):583-596.DOI:10.1016/j.infbeh.2014.08.001.
[4]廖红霞,杨志雄.以家庭为中心的护理模式在早产儿过渡病房中的应用[J].中国社区医师,2018,34(10):152-153.
[5]WIELENGA J M,TUME L N,LATOUR J M,et al.Europeanneonatal intensive care nursing research priorities:an eDelphi study[J]. Archives of Disease in Childhood-Fetaland Neonatal Edition,2014,100(1):66-71.DOI:10.1136/archdischild-2014-306858.
[6]闫雪梅,马衣努尔·托合提,王益兰,等.胸腹腔镜食管癌根治术围手术期患者护理结局及指标类目的构建[J].护理管理杂志,2017,17(12):902-905.
[7]李淑花,袁丽荣,商临萍.呼吸内科住院患者健康教育评价指标体系的构建[J].护理管理杂志,2016,16(9):617-619.
[8]邱礼荣,韩晶,周丽娟,等.运用Delphi法构建手术室新护士培训课程指标体系[J].护理管理杂志,2018,18(7):512-514.DOI:10.3969/j.issn.1671-315x.2018.07.013.
[9]田媛,李凌,胡莉萍.基于Kano模型改进老年科护理服务[J].护理学杂志,2017,32(7):1-3.DOI:0.3870/j.issn.1001-4152.2017.07.001.
[10]GUTKNECHT M,DANNER M,SCHAARSCHMIDT M L,et al. Assessing the importance of treatment goals in pa-tients with psoriasis:analytic hierarchy pocess vs. Likertscales[J]. The Patient,2018,11(4):425-437. DOI:10.1007/s40271-018-0300-1.
[11]MUHLBACHER A C,BETHGE S,KACZYNSKI A,et al.Objective criteria in the medicinal therapy for type II dia-betes:an analysis of the patients’ perspective with analytichierarchy process and best-worst scaling[J]. Gesundhe-itswesen,2016,78(5):326-336.DOI:10.1055/s-0034-1390474.
[12]李月仪,陈伟菊.德尔菲法在护理管理学中的应用现状[J].护理研究,2018,32(21):3339-3341. DOI:10.12102/j.issn.1009-6493.2018.21.006.
[13]李梁,杨楠,任红,等.德尔菲法构建临床护理人员人文关怀能力评价指标体系[J].护理研究,2016,30(27):3376-3379.DOI:10.3969/j.issn.1009-6493.2016.27.016.
[14]朱玲玲,韩瑜姣,毕越英.应用Delphi法构建三级甲等医院科室分类模型护理指标体系的研究[J].护理管理杂志,2015,15(3):159-161.
[15]张桃桃,黄正新,吴君,等.基于德尔菲法研制住院患者社会适应能力评估量表[J].护理学杂志,2014,29(13):65-67.DOI:10.3870/hlxzz.2014.13.065.
[16]EDMUNDS S, HAINES L, BLAIR M. Development of aquestionnaire to collect public health data for school en-trants in London:Child Health Assessment at School Entry(CHASE)project[J]. Child:Care,Health and Develop-ment,2005,31(1):89-97.
[17]宋婷婷,张秀英,张岚,等.新生儿重症监护室患儿家属焦虑状况研究进展[J].中国护理管理,2012,12(6):81-83.
[18]闵丽华,张小建,曹学华,等.以家庭为中心的产科服务模式对接受辅助生殖技术产妇的影响[J].护理管理杂志,2013,13(1):30-31.
[19]李娟,王庆红,吴红敏,等.2005年中国城市产科新生儿出生状况调查[J].中国当代儿科杂志,2012,14(1):7-10.
[20]陈洁琼,毛莹,江宇.综合护理干预对剖宫产产妇母婴分离成功母乳喂养的影响[J].医学理论与实践,2018,31(23):3625-3626.
[21]CHERYL L H,LINDA W,SUSAN A,等.以家庭为中心护理模式的探讨及安全管理[J].中国循证儿科杂志,2009,4(6):481-484.
[22]史丽荣,马颖,芦献丽,等.FCC优质护理理念在新生儿健康教育中的应用[J].护理研究, 2013, 27(1):254-255.
[23]占六娇,余胜春.对大别山地区出院后早产儿健康教育的探讨[J].中国保健营养,2013,1(1):186-187.
[24]AHLQVIST-BJORKROTH S,BOUKYDIS Z,AXELIN AM,et al. Close collaboration with parents intervention toimprove parents’ psychological well-being and child de-velopment:Description of the intervention and study proto-col[J].Behavioural Brain Research,2017,325:303-310.DOI:10.1016/j.bbr.2016.10.020.
[25]罗家国,邱庚香,潘莎莎.基于克伦巴赫信度分析的工科学生实践教学质量评价之改进[J].创新与创业教育,2015,6(2):140-143.
[26]朱惠,李德华,涂玉芹,等.Kano模型调查结果分析对改进门诊服务的指导意义[J].华西医学,2017,32(9):1446-1448.
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