基于德尔菲法构建成人ICU患者压力性损伤风险评估工具
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摘要
目的构建科学、可行的成人ICU患者压力性损伤风险评估工具。方法在文献调研和小组讨论的基础上,运用德尔菲法对20名ICU相关领域专家进行2轮咨询,确定风险评估工具。结果 2轮专家咨询中,问卷回收率均为100%,权威系数分别为0.857和0.865,最终确定的一级条目重要性评分均数为4.30～4.95,满分比为0.30～0.95,变异系数为0.05～0.11;等级条目准确性评分均数为4.05～4.80,满分比为0.25～0.80,变异系数为0.09～0.18。2轮咨询专家的肯德尔协调系数分别为0.310和0.376(P<0.001),最终构建了包含7个一级条目和25个等级条目的成人ICU患者压力性损伤风险评估工具。结论本研究基于德尔菲法构建的风险评估工具具有较高的科学性和可靠性,可为成人ICU患者压力性损伤风险评估工作提供一定的参考依据。
Objective To develop a scientific and feasible pressure injury risk assessment tool for adult ICU patients. Methods The risk assessment tool was developed after literature review, group discussion and two-round expert consultations conducted among 20 experts in ICU related fields. Results In two rounds of surveys, response rates of the questionnaire were 100% and 100% respectively and the authoritative coefficients were 0.857 and 0.865 respectively. Eventually determine the mean value of importance scoring of first-level items ranged from 4.30 to 4.95, the full score ratio from 0.30 to 0.95, the variation coefficient from 0.05 to 0.11; The mean value of accuracy scoring of the secondary items ranged from 4.05 to 4.80, the full score ratio from 0.25 to 0.80, the variation coefficient from 0.09 to 0.18. The Kendall's coordination coefficients of the two rounds of consultation were 0.310 and 0.376 respectively(P<0.001). Finally, an adult ICU risk assessment tool for pressure injury containing 7 first-level items and 25 secondary-level items was constructed. Conclusion The risk assessment tool based on Delphi method have high scientific and reliability, which can provide certain reference for the risk assessment of pressure injury in adult ICU patients.
Objective To develop a scientific and feasible pressure injury risk assessment tool for adult ICU patients. Methods The risk assessment tool was developed after literature review, group discussion and two-round expert consultations conducted among 20 experts in ICU related fields. Results In two rounds of surveys, response rates of the questionnaire were 100% and 100% respectively and the authoritative coefficients were 0.857 and 0.865 respectively. Eventually determine the mean value of importance scoring of first-level items ranged from 4.30 to 4.95, the full score ratio from 0.30 to 0.95, the variation coefficient from 0.05 to 0.11; The mean value of accuracy scoring of the secondary items ranged from 4.05 to 4.80, the full score ratio from 0.25 to 0.80, the variation coefficient from 0.09 to 0.18. The Kendall's coordination coefficients of the two rounds of consultation were 0.310 and 0.376 respectively(P<0.001). Finally, an adult ICU risk assessment tool for pressure injury containing 7 first-level items and 25 secondary-level items was constructed. Conclusion The risk assessment tool based on Delphi method have high scientific and reliability, which can provide certain reference for the risk assessment of pressure injury in adult ICU patients.
引文
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[11] 谢樱姿,徐翠荣,李国宏,等.护理用药系统满意度调查问卷的研制及信效度分析[J].护士进修杂志,2016,31(19):1733-1737.
[12] 乔够梅,张晓丽,王养民,等.尿路造口患者健康教育评价标准的构建[J].中华护理杂志,2014,49(9):1058-1061.
[13] 王俏,赵毅,刘伟,等.应用Delphi法研制功能性消化不良患者健康行为自我效能量表[J].中国实用护理杂志,2012,28(32):66-68.
[2] Bours G J,Halfen R J,Berger M P,et al.Development of a model for case-mix adjustment of pressure ulcer prevalence rates[J].Med Care,2003,41(1):45-55.
[3] Bennett G,Dealey C,Posnett J.The cost of pressure ulcers in the UK[J].Age Ageing,2004,33(3):230-235.
[4] Brindle C T,Malhotra R,O’Rourke S,et al.Turning and repositioning the critically ill patient with hemodynamic instability[J].Journal of Wound,Ostomy and Continence Nursing,2013,40(3):254-267.
[5] Hughes R G.Patient safety and quality:A evidence-based handbook for nurses[M].Rockville:AHRQ Publication,2008.
[6] Moore Z E,Cowman S.Risk assessment tool for the prevention of pressure ulcers[J].Cochrane of Systematic Riviews,2008,16(3):CD006471.
[7] 陈晓燕.3种压疮危险评估量表在神经外科ICU病人中的应用研究[J].护理研究,2016,30(3):1081-1083.
[8] Jackson C.The revised Jackson/Cubbin Pressure Area Risk Calculator[J].Intensive and Critical Care Nursing,1996,15(3):169-175.
[9] Boyle M,Green M.Pressure sores in intensive care:defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools[J].Australian Critical Care,2001,14(1):24-30.
[10] 查丽玲,王建宁,榕江.江西省三级甲等医院ICU护理安全管理指标体系的构建[J].护理学杂志,2013,28(17):10-12.
[11] 谢樱姿,徐翠荣,李国宏,等.护理用药系统满意度调查问卷的研制及信效度分析[J].护士进修杂志,2016,31(19):1733-1737.
[12] 乔够梅,张晓丽,王养民,等.尿路造口患者健康教育评价标准的构建[J].中华护理杂志,2014,49(9):1058-1061.
[13] 王俏,赵毅,刘伟,等.应用Delphi法研制功能性消化不良患者健康行为自我效能量表[J].中国实用护理杂志,2012,28(32):66-68.