| 王芳,季维辉,闻红梅,吴龙辉,姚爱红,陆敏,蔡敏佳.基于Delphi咨询的居家腹膜透析患者社区延续性护理服务清单开发研究[J].上海护理,2022,22(1): |
| 基于Delphi咨询的居家腹膜透析患者社区延续性护理服务清单开发研究 |
| Research on the development of community continuous nursing service list for home peritoneal dialysis patients based on Delphi consultationWANG Fang1, JI Weihui2, WEN Hongmei2*,WU Longhui1,YAO Aihong1,Lu Min1,Cai Minjia1 |
| DOI： |
| 中文关键词: 居家腹膜透析 延续护理 社区 |
| 英文关键词:Home peritoneal dialysis Continuous services Community |
| 基金项目:2018年度上海市中西医结合学会社区医学和健康管理科研课题（2018SQ004)；2020年度金山区医药卫生类科技创新基金项目(2020-3-56-PAS202007253268) |
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| 中文摘要: |
| 目的：构建社区居家腹膜透析护理服务目录,为社区开展居家腹膜透析护理提供依据。方法：于2019年6月至2019年8月期间,邀请综合医院和社区卫生服务中心腹膜透析相关专家参与咨询,对研究组基于文献回顾和需方调研梳理的29项服务的重要性进行评价。咨询采用两轮Dephi法进行。数据分析是在SPSS24.0和EXCEL 2016环境下进行,以P<0.05为具有统计学意义。结果：共16位专家参与了咨询,专家权威程度为：第一轮,0.80,第二轮0.83,均大于0.7,表明专家权威性较佳。两轮Kendall协调系数分别位0.378、0.202,专家意见未趋同。经两轮咨询,剔除“建立腹膜透析患者的微信群或QQ群”和“定期组织腹膜透析相关的专题讲座”两个项目,最终保留27项服务,包含自我护理培训、建档与随访、心理社会支持和个性化指导四大类内容。结论：居家腹膜透析患者的延续性护理需兼顾患者生理、心理、社会等多方面需求,生理问题的护理,旨在解决患者透析行为不规范、透析并发症识别等问题,心理、社会等问题的护理,不仅是要在患者自身面临心理或社会压力时进行疏导,更需要就产生压力的原因进行深入了解,提供个性化的辅导和资源引入。 |
| 英文摘要: |
| Objective: To establish a community-based nursing service directory for home peritoneal dialysis and to provide a basis for the community to develop home peritoneal dialysis nursing. Methods: From June 2019 to August 2019, experts in peritoneal dialysis from general hospitals and community health centers were invited to participate in the consultation, and the importance of 29 services, based on literature review from the research group and combed by the demand-side after investigation, was evaluated. The consultation was conducted using two rounds of Dephi and data analysis was performed in SPSS24.0 and EXCEL 2016 with the significant level of 0.05. Results: A total of 16 experts participated in the consultation. The coefficient of the expert authorities was 0.80 in the first round and 0.83 in the second round, which were all greater than 0.7, indicating that the authority of the experts was perfect. The Kendall coordination coefficients for the two rounds were 0.378 and 0.202, respectively, suggesting that expert opinions did not converge. After two rounds of consultations, the two projects, “establishing WeChat group or QQ group of peritoneal dialysis patients” and “periodic organization of special lectures on peritoneal dialysis”, were eliminated while the remaining 27 services were finally retained, including four categories: self-care training, filing and follow-up, psychosocial support and personalized guidance. Conclusion: Continuous nursing service for home peritoneal dialysis patients should take into account the various physical, psychological, and social needs of the patients. Further, physiological nursing is designed to solve problems such as irregular dialysis behaviors, identification of dialysis complications. In addition, psychological and social nursing is not only to guide patients when they are facing psychological or social pressure, but also to understand the causes of stress in depth, and to provide personalized counseling and resource introduction. |
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