基于德尔菲法的口腔颌面头颈肿瘤患者气管切开居家护理方案的构建

doi:10.19438/j.cjoms.2022.04.010

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (4): 371-377.doi: 10.19438/j.cjoms.2022.04.010

基于德尔菲法的口腔颌面头颈肿瘤患者气管切开居家护理方案的构建

徐诸凤^1,2, 侯黎莉^1,*, 王悦平^1,*, 谢瑜婷¹, 刘浏³, 郁玺玺¹

1.上海交通大学医学院附属第九人民医院护理部,上海 200011;
2.上海交通大学医学院护理学院,上海 200025;
3.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海 200011

收稿日期:2022-04-24 修回日期:2022-05-25 出版日期:2022-07-20 发布日期:2022-07-20
通讯作者: 侯黎莉,E-mail:pisces_1iz@163.com;王悦平,E-mail:18121213995@163.com。^*共同通信作者
作者简介:徐诸凤（1992-）,女,本科,护师,E-mail:724047219@qq.com
基金资助:
长三角科技创新共同体领域项目(21002411300); 上海高水平地方高校创新团队(SHSMU-ZDCX20212802); 上海交通大学医学院科技基金项目(Jyhz2017); 上海交通大学医学院附属第九人民医院护理院基金(JYHL2021MS05)

Construction of home care program for patients with oromaxillofacial head and neck tumor undergoing tracheotomy based on Delphi method

XU Zhu-feng^1,2, HOU Li-li¹, WANG Yue-ping¹, XIE Yu-ting¹, LIU Liu³, YU Xi-xi¹

1. Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
2. Shanghai Jiao Tong University School of Nursing. Shanghai 200025;
3. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2022-04-24 Revised:2022-05-25 Online:2022-07-20 Published:2022-07-20

摘要/Abstract

摘要： 目的: 构建口腔颌面头颈肿瘤患者气管切开居家护理方案。方法: 在前期文献分析、半结构式访谈及理论框架的基础上,构建口腔颌面头颈肿瘤患者气管切开居家护理方案初稿。通过德尔菲法对15名专家进行2轮咨询,得到最终方案。采用SPSS 25.0软件包对数据进行统计分析。结果: 2轮专家咨询回收率均为100%,整体专家权威系数为0.88。重要性变异系数为0~0.16,可行性变异系数为0~0.17。最终构建的方案包括4个一级指标、9个二级指标和31个三级指标。结论: 口腔颌面头颈肿瘤患者气管切开居家护理方案符合该群体的居家照护需求,方案构建具有科学性、可行性,能为临床护理实践提供参考依据。

关键词: 口腔颌面头颈肿瘤, 气管切开, 居家护理, 德尔菲法

Abstract: PURPOSE: To construct a home care program of tracheotomy for patients with oromaxillofacial head and neck tumor. METHODS: Based on content analysis of the literature, semi-structured?interviews and theoretical framework, the first draft of home care program for patients with oromaxillofacial head and neck tumor was constructed. Delphi method was used to carry out two rounds of mail inquiry to 15 experts in relevant fields to determine the final scheme. SPSS 25.0 software package was used for data analysis. RESULTS: The questionnaire return rate of the two rounds of expert consultation was 100% and the overall expert authority coefficient was 0.88. The coefficient of variation of importance was 0-0.16 and the coefficient of variation of feasibility was 0-0.17. The scheme included 4 primary indicators, 9 secondary indicators and 31 tertiary indicators. CONCLUSIONS: The home care program of tracheotomy for patients with oromaxillofacial head and neck tumor constructed in this study meets the needs of this group of patients. The construction of the program is scientific and feasible, also provides a reference for clinical practice.

Key words: Oromaxillofacial head and neck tumor, Tracheotomy, Home care, Delphi method

中图分类号:

R739.8

徐诸凤, 侯黎莉, 王悦平, 谢瑜婷, 刘浏, 郁玺玺. 基于德尔菲法的口腔颌面头颈肿瘤患者气管切开居家护理方案的构建[J]. 中国口腔颌面外科杂志, 2022, 20(4): 371-377.

XU Zhu-feng, HOU Li-li, WANG Yue-ping, XIE Yu-ting, LIU Liu, YU Xi-xi. Construction of home care program for patients with oromaxillofacial head and neck tumor undergoing tracheotomy based on Delphi method[J]. China J Oral Maxillofac Surg, 2022, 20(4): 371-377.

参考文献

[1] 王斌全, 高伟, 吴勇延. 头颈肿瘤多组学研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(23): 1785-1792.
Wang BQ, Gao W, Wu YY.Progress in multi-omic study of head and neck cancer[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(23): 1785-1792.
[2] Siegel RL, Miller KD, Jemal A.Cancer statistics, 2016[J]. CA Cancer J Clin, 2016, 66(1): 7-30.
[3] 李晔雄. 肿瘤放射治疗学[M]. 第5版. 北京: 中国协和医科大学出版社, 2018: 1788.
Li YX.Radiation oncology[M]. 5th Edition. Beijing: China Union Medical College Press, 2018: 1788.
[4] 徐诸凤, 郁玺玺, 王悦平. 晚期口腔癌患者术后家庭照顾者的需求现状[J]. 中国口腔颌面外科杂志, 2019, 17(1): 82-85.
Xu ZF, Yu XX, Wang YP.Demand status of family cares for postoperative patients with advanced oral cancer[J]. China Journal of Oral and Maxillofacial Surgery, 2019, 17(1): 82-85.
[5] McCormick ME, Ward E, Roberson DW, et al. Life after tracheostomy: patient and family perspectives on teaching, transitions, and multidisciplinary teams[J]. Otolaryngol Head Neck Surg, 2015, 153(6): 914-920.
[6] Tofil NM, Schier S, Benningfield B, et al.Tracheostomy education for parents utilizing simulation: a new paradigm in parental education[J]. Pediatr Nurs, 2018, 44(3): 1-8.
[7] Alam R, Rehana M, Raied A.Obligation of home care education for tracheostomy[J]. Saf Health, 2017, 3(1): 2-4.
[8] Kaur A, Qureshi A.Effectiveness of a video teaching programme regarding tracheostomy care on knowledge and skills of care providers of tracheostomized patients at AIIMS, New Delhi[J]. Int J Sci Res, 2017, 6(7): 1446-1452.
[9] 徐金静, 王经梅, 杨爱春. 气管切开带管出院患者的微信延续护理[J]. 实用临床医药杂志, 2018, 22(20): 12-14.
Xu JJ, Wang JM, Yang AC.Wechat platform continuous nursing for patients with indwelling tube after tracheotomy at discharge[J]. Journal of Clinical Medicine in Practice, 2018, 22(20): 12-14.
[10] 王帅颖, 刘琴, 韩媛, 等. 4C延续性护理模式在临床护理中的应用进展[J]. 中国医药科学, 2020, 10(21): 41-44.
Wang SY, Liu Q, Han Y, et al.Application progress of 4C continuous nursing model in clinical nursing[J]. China Medicine and Pharmacy, 2020, 10(21): 41-44.
[11] 杨扬, 仰曙芬, 付玉, 等.临床医学硕士专业学位研究生学位论文质量评价体系的构建[J].中华医学教育探索杂志, 2016, 15(12): 1205-1209.
Yang Y, Yang SF, Fu Y, et al.Construction of the quality evaluation system of master academic dissertation of post graduates major in professional clinical medicine[J]. Chinese Journal of Medical Education Research, 2016, 15(12): 1205-1209.
[12] 周芝华, 王玉侠, 宗美英. 基于德尔菲法构建泌尿造口患者延续护理方案[J].全科护理, 2019, 17(29): 3632-3636.
Zhou ZH, Wang YX, Zong MY.Construction of continuous nursing program for urostomy patients based on Delphi method[J]. Chinese General Practice Nursing, 2019, 17(29): 3632-3636.
[13] 伍琳, 孙艳杰. 德尔菲法简介及在护理学中的应用现状[J]. 护理研究: 中旬版, 2015, 29(10): 3599-3601.
Wu L, Sun YJ.Delphi method introduction and its application status quo in “nursing science”[J]. Chinese Nursing Research, 2015, 29(10): 3599-3601.
[14] 郑窑文, 蒋莉莉, 胡嘉乐, 等. 基于德尔菲法构建老年口腔癌患者围术期口腔护理方案[J]. 上海口腔医学, 2020, 29(2): 192-201.
Zheng YW, Jiang LL, Hu JL, et al.Construction of perioperative oral care program for elderly patients with oral cancer based on Delphi method[J]. Shanghai Journal of Stomatology, 2020, 29(2):192-201.
[15] 汤爱玲. 上海市专科护士培养与管理方案的研究[D]. 上海: 第二军医大学, 2016.
Tang AL.A qualitative study on the training and management scheme of specialty nurses in Shanghai[D]. Shanghai: The Second Military Medical University, 2016.
[16] 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.
Li YL, Chen WJ.Application status quo of Delphy method in nursing management[J]. Chinese Nursing Research, 2018, 32(21): 3339-3341.
[17] 王少娜, 董瑞, 谢晖, 等. 德尔菲法及其构建指标体系的应用进展[J]. 蚌埠医学院学报, 2016, 41(5): 695-698.
Wang SN, Dong R, Xie H, et al.Application progress of Delphi method and its index system[J]. Journal of Bengbu Medical College, 2016, 41(5): 695-698.
[18] Mitchell RB, Hussey HM, Setzen G, et al.Clinical consensus statement: tracheostomy care[J]. Otolaryngol Head Neck Surg, 2013, 148(1): 6-20.
[19] 张惠荣, 李会琴, 张丹, 等. 咽喉肿瘤术后患者出院培训指导的效果评价[J].中国护理管理, 2015(2): 230-232, 233.
Zhang HR, Li HQ, Zhang D, et al.Discharge training guidance and effect evaluation among throat tumor patients[J]. Chinese Nursing Management, 2015(2): 230-232, 233.
[20] Loerzel VW, Crosby WW, Reising E, et al.Developing the tracheostomy care anxiety relief through education and support (T-CARES) program[J]. Clin J Oncol Nurs, 2014, 18(5): 522-527.
[21] 卫琦琼. 工作坊培训模式在喉癌气管切开患者中的应用效果评价[J].上海护理, 2021, 21(11): 1-4.
Wei QQ.Evaluation of effect of workshop training mode on patients with laryngeal carcinoma undergoing tracheotomy[J]. Shanghai Nursing, 2021, 21(11): 1-4.
[22] 廖娜, 马俊, 李燕. 延续护理在预防带管出院患者气管导管并发症中的效果观察[J]. 西南医科大学学报, 2018, 41(1): 86-89.
Liao N, Ma J, Li Y.Effect of continuous nursing care on the prevention of complications in discharged patients with tracheal catheter[J]. Journal of Luzhou Medical College,2018,41(1): 86-89.
[23] Wang TJ, Lu MH, Kuo PL, et al.Influences of facial disfigurement and social support for psychosocial adjustment among patients with oral cancer in Taiwan: a cross-sectional study[J]. BMJ Open, 2018, 8(11): e023670.
[24] 辜德英. 医护一体化互联网+随访模式在头颈肿瘤患者随访管理中的应用[J]. 护理实践与研究, 2021, 18(11):1675-1679.
Gu DY.Application of integrated medical care Internet + follow-up mode in follow-up management of head and neck cancer patient[J]. Nursing Practice and Research, 2021, 18(11): 1675-1679.
[25] 吕俭霞, 殷利, 程平, 等. 头颈肿瘤患者支持性照护需求与社会支持, 焦虑及抑郁的相关性研究[J]. 循证护理, 2021, 7(8): 1021-1025.
Lu JX, Yin L, Cheng P, et al.Study on the correlation among the supportive care needs and social support, anxiety and depression of patients with head and neck tumors[J]. Chinese Evidence-based Nursing, 2021, 7(8): 1021-1025.
[26] 耿芹, 仲美华. 微信平台在神经外科气管切开带管出院患者延续性护理中的效果研究[J]. 实用临床护理学电子杂志, 2018, 3(43): 55-57.
Geng Q, Zhong MH.Effect of wechat platform on continuous nursing care of neurosurgery patients discharged with tracheotomy tube[J]. Journal of Clinic Nursing's Practicality, 2018, 3(43): 55-57.
[27] 吴培曼, 吴培赛, 毛悦悦. 运用微信平台为喉癌术后带管出院病人提供延续护理的效果[J]. 全科护理, 2018, 16(15): 1839-1840.
Wu PM, Wu PS, Mao YY.Effect of using WeChat platform to provide continuous nursing care for patients discharged with laryngeal cancer after operation[J]. Chinese General Practice Nursing, 2018, 16(15): 1839-1840.
[28] 国务院办公厅.关于推进分级诊疗制度建设的指导意见[R]. 北京, 2015.
General Office of the State Council. Guiding opinions on promoting the construction of graded diagnosis and treatment system[R]. Beijing, 2015.
[29] 国家卫生健康委员会. 关于促进护理服务行业改革与发展的指导意见[J]. 中国护理管理, 2018, 18(7): 865-867.
National Health Commission.Guiding opinions on promoting the reform and development of nursing service industry[J]. Chinese Nursing Management, 2018, 18(7): 865-867.

基于德尔菲法的口腔颌面头颈肿瘤患者气管切开居家护理方案的构建

Construction of home care program for patients with oromaxillofacial head and neck tumor undergoing tracheotomy based on Delphi method

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 5

编辑推荐

Metrics

本文评价

[1]	王悦平, 徐诸凤, 施佳敏, 袁卫军, 侯黎莉. “新冠”疫情下一种新型气管切开导管防护装置在口腔肿瘤患者中的应用[J]. 中国口腔颌面外科杂志, 2023, 21(2): 137-141.
[2]	朱博文, 庄海, 毛秋怡, 卜寿山. 4种评分系统判断口腔癌患者术后气管切开需求的准确性评价[J]. 中国口腔颌面外科杂志, 2022, 20(2): 129-134.
[3]	李燕, 黄瑶, 倪莹, 杨悦来, 殷琦. 头颈肿瘤患者重症监护期间睡眠促进方案的构建与评价[J]. 中国口腔颌面外科杂志, 2022, 20(1): 68-71.
[4]	吴嘉骏, 夏伟梁, 范晶娴, 李颖川, 韦贤, 郭长峰, 黄洁, 徐兵, 卢洪洲. 2019-nCoV重症患者气管切开防喷溅装置的设计与初步应用[J]. 中国口腔颌面外科杂志, 2020, 18(3): 210-213.
[5]	雷书赞, 汪接兵, 张银喜. 气管切开全麻下无水乙醇栓塞治疗咽喉部静脉畸形20例报道[J]. 中国口腔颌面外科杂志, 2019, 17(1): 74-76.