基于时机理论肠造口患儿父母阶段干预方案的构建

doi:10.16460/j.issn1008-9969.2022.05.074

摘要/Abstract

摘要： 目的构建基于时机理论肠造口患儿父母的阶段干预方案。方法以时机理论为指导,通过文献回顾拟定干预方案初稿,选取10名专家经过2轮专家函询,对干预时期和具体措施进行修改,构建肠造口患儿父母的阶段干预方案。结果 2轮专家函询问卷回收率和专家积极性均为100%,专家权威系数Cr均>0.90,Kendall’s W系数分别为0.223和0.293,具有统计学意义（P<0.05）。经过2轮专家函询,最终确定围术期、出院准备期、调整期和适应期共4个干预阶段,包括在院发送宣教手册和视频,指导家属肠造口模型练习,出院后线下造口护理专科门诊结合互联网线上诊疗提供延续性护理服务等13项干预措施。结论通过德尔菲法构建基于时机理论肠造口患儿父母阶段干预方案,具有科学性和可靠性,可为制定肠造口患儿及其父母不同阶段的照顾支持和开展延续性护理提供借鉴和指导。

关键词: 时机理论, 肠造口, 父母, 德尔菲, 干预方案

Abstract: Objective To construct a phase intervention program for parents of infants with enterostomy based on Timing it Right (TIR) theory. Methods Based on the framework of TIR theory, the draft of the intervention program was developed after literature review, and 10 experts were selected to modify the intervention period and specific measures after 2 rounds of expert letter consultation. Finally, the construction of the phase intervention program for parents of infants with enterostomy was completed. Results The recovery rate and enthusiasm of experts were 100%; the expert authority coefficients were all greater than 0.90, and Kendall’s W coefficients were 0.223 and 0.293, respectively, with statistical significance (P<0.05). After two rounds of expert consultation, four intervention phases which included perioperative period, discharge preparation period, adjustment period and adaptation period, were finally determined, and 13 intervention measures, including sending education handbook and video in the hospital, guiding how to make use of enterostomy model to practice, and the combination of ostomy nursing specialist outpatient service and online extended care service after discharge, etc. Conclusion The TIR theory-based phase intervention program for parents of infants with enterostomy is scientific and reliable, which provides reference and guidance for the formulation of nursing support and the development of extending nursing for infants with enterostomy as well as their parents in different phases.

Key words: timing it right, enterostomy, parent, Delphi, intervention program

中图分类号:

R473.72

黄文娟, 吴冬梅, 詹丽如. 基于时机理论肠造口患儿父母阶段干预方案的构建[J]. 护理学报, 2022, 29(5): 74-78.

HUANG Wen-juan, WU Dong-mei, ZHAN Li-ru. Construction of Timing It Right Theory-based Phase Intervention Program for Parents of Infants with Enterostomy[J]. Journal of Nursing, 2022, 29(5): 74-78.

参考文献

[1] 张玉侠. 新生儿实用护理学[M].北京:人民卫生出版社,2019:343.
[2] 耿守凡,王月琦,张丹,等. 肠造口新生儿母亲照护体验的质性研究[J].护士进修杂志, 2019, 34(3):244-246. DOI:10.16821/j.cnki.hsjx.2019.03.013.
[3] Vance AJ, Knafl K, Brandon DH. Patterns of Parenting Confidence Among Infants with Medical Complexity:A Mixed-methods Analysis[J]. Adv Neonatal Care,2021,21(2):160-168. DOI:10.1097/A NC.0000000000000754.
[4] 张楠,韩月姣,王亚菲,等. 105例肠造口患儿主要照顾者照顾负担现状及影响因素分析[J]. 护理学报, 2019,26(18):51-54. DOI:10.16460/j.issn1008-9969.2019.18.051.
[5] Li OM, Wu LJ, Huang YL, et al. Nursing Care for Infants after Enterostomy: Experience with 483 Cases Over a 5-Year Period[J]. J Nurs Manag,2019,27(8):1614-1619. DOI:10.1111/jonm.12844.
[6] Zhang X, Gao R, Lin JL, et al. Effects of Hospital-family Holistic Care Model on the Health Outcome of Patients with Permanent Enterostomy Based on the Theory of ‘Timing It Right'[J]. J Clin Nurs, 2020, 29(13-14):2196-2208. DOI: 10.1111/jocn.15199.
[7] 雷娜,任向芳,郭露萍,等.延续护理在降低新生儿肠造口并发症发生率中的效果观察[J].护理管理杂志, 2016,16(6):430-431.
[8] 张楠,韩月皎,苏莉莉,等.儿童肠造口延续性护理现状及研究进展[J].中国护理管理,2020,20(8):1183-1187. DOI:10.3969/j.issn.1672-1756.2020.08.014.
[9] 曹晶,赵颖,何许,等.基于循证构建肠造口患者护理团队核心要素指标体系[J].护理学报, 2020, 27(1):64-69. DOI: 10.16460/j.issn1008-9969.2020.01.064.
[10] Cameron JI, Gignac MA. “Timing It Right”: A Conceptual Framework for Addressing the Support Needs of Family Caregivers to Stroke Survivors from the Hospital to the Home[J]. Patient Educ Couns, 2008, 70(3):305-314. DOI: 10.1016/j.pec.2007.10.020.
[11] 胡爱玲,郑美娟,李伟娟.现代伤口与肠造口临床护理实践[M].2版.北京:中国协和医科大学出版社,2018:446-450.
[12] 卞荆晶,朱丹,胡露红.以家庭为中心护理模式在造口患儿中的应用研究[J].护理学杂志,2014, 29(16):4-6. DOI:10.3870/hlxzz.2014.16.004.
[13] World Councill of Enterostomal Therapists.WCET International Ostomy Guideline[EB/OL].[2021-06-29].https://wcetonline-store.myshopify.com/products /international-ostomy-guideline downloadable.
[14] 中国肠造口护理指导意见编委会.中国肠造口护理指导意见2013版[M]. 北京:中华护理学会造口、伤口、失禁护理专业委员会, 2013.
[15] The World Council of Enterostomal Therapists. International Ostomy Guideline 2nd Edition[EB/OL]. [2021-06-29]. https://wcet-online-store.myshopify.com/collections/all.
[16] 唐云跃,岳树锦,郭彤,等.国外最佳肠造口临床实践指南健康教育推荐意见的分析研究[J].护理研究, 2020,34(10):1733-1738. DOI: 10.12102/j.issn.1009-6493.2020.10.010.
[17] 司龙妹,刘飞,张佩英,等.造口患者围手术期健康教育的最佳证据总结[J].中华护理杂志,2021,56(3):452-457. DOI: 10.3761/j.issn.0254-1769.2021.03.024.
[18] Robatmili A, Anboohi SZ, Farahani A, et al. Effect of Providing Ostomy Care Education to Mothers of Neonates with Peristomal Skin Complications[J]. Adv Nurs Midwifery,2018,27(3):6-10. DOI:10.21859/ANM-027033.
[19] Prinz A, Colwell JC, Cross HH, et al. Discharge Planning for a Patient with a New Ostomy:Best Practice for Clinicians[J]. J Wound Ostomy Continence Nurs, 2015,42(1):79-82. DOI: 10.1097/WON.0000000000000094.
[20] Goudarzi Z, Askari M, Seyed-Fatemi N, et al. The Effect of Educational Program on Stress, Anxiety and Depression of the Mothers of Neonates Having Colostomy[J]. J Matern Fetal Neonatal Med,2016,29(23):3902-3905. DOI:10.3109/14767058.2016.1152242.
[21] Mcdonald J, Mckinlay E, Keeling S, et al. Becoming an Expert Carer: The Process of Family Carers Learning to Manage Technical Health Procedures at Home[J]. J Adv Nurs, 2016, 72(9):2173-2184. DOI:10.1111/jan.12984.
[22] 苏锦绣,李丽红.互联网+智慧医院背景下伤口造口失禁专科护理管理实践[J].护理研究,2021, 35(4):728-730. DOI:10.12102/j.issn.1009-6493.2021.04.035.
[23] 唐文娟,陆群峰,屈文倩,等.动机性访谈在肠造口患儿照顾者中的应用[J].中华护理杂志,2019,54(6):896-901. DOI:10.3761/j.issn.0254-1769.2019.06.018.
[24] 吴玲,魏敏,夏冬云,等.肠造口患者出院准备度指标的构建[J].中国护理管理,2021,21(4):512-516.DOI:10.3969/j.issn.1672-1756.2021.04.008.
[25] Dabas H, Sharma K K, Joshi P, et al. Video Teaching Program on Management of Colostomy: Evaluation of Its Impact on Caregivers[J]. J Indian Assoc Pediatr Surg, 2016, 21(2):54-56. DOI:10.4103/0971-9261.176933.
[26] 刘美玲,殷彩欣,符白玲,等.妇女儿童互联网护理门诊建设实践[J].中国护理管理,2021,21(2):293-297. DOI:10.3969/j.issn.1672-1756.2021.02.027.

相关文章 15

[1]	郭林芳, 张培莉, 侯晓雅, 李滢, 曹敏, 高超越. 肝癌化疗患者线上线下结合营养干预方案的构建[J]. 护理学报, 2025, 32(4): 1-5.
[2]	田美雨, 王翠玲, 高若男, 田佳, 刘怡. 妇科肿瘤科护士性健康照护培训方案的构建[J]. 护理学报, 2025, 32(4): 18-23.
[3]	全伊萍, 陈霞, 胡琼丹. 脑心健康管理师核心胜任力评价指标体系的构建[J]. 护理学报, 2024, 31(9): 5-9.
[4]	陈芮, 王梅, 唐晓霞, 朱傲雪, 毛惠娜. 基于ERG理论的免疫检查点抑制剂治疗癌症患者护理需求方案的构建[J]. 护理学报, 2024, 31(7): 1-5.
[5]	陈坚, 项丽君, 罗彦嗣, 陈建辉, 崔艳丽, 廖琳, 颜明玉, 张晓梅. 脑卒中后吞咽障碍患者“互联网+”延续性康复管理方案的构建[J]. 护理学报, 2024, 31(24): 1-6.
[6]	林梅燕, 张星星, 李瑞华, 陶思琪, 甄莉. 肠造口患者居家睡眠质量特点及影响因素研究进展[J]. 护理学报, 2024, 31(24): 27-32.
[7]	戴倩, 刘翔宇, 朱小妹, 王佳丽, 黄远思. 结直肠癌造口患者自我同情现状及影响因素研究[J]. 护理学报, 2024, 31(23): 13-17.
[8]	张星星, 李瑞华, 朱木兰, 林梅燕, 李雅男, 龚立红, 曾海婷, 甄莉. 成人肠造口患者高排量预防与管理的最佳证据总结[J]. 护理学报, 2024, 31(23): 73-78.
[9]	张倩君, 毛小英, 张莉, 刘俏玲, 向霞, 冯结兰, 冼顺英, 张璠, 邓伟英, 白志宝. 218名肠造口患者家庭照顾者的心理脱离现状及影响因素分析[J]. 护理学报, 2024, 31(22): 7-11.
[10]	李小梅, 陶明, 李茜茜, 李琳琳, 李春. 基于症状管理理论神经源性膀胱患者自我管理干预方案的构建[J]. 护理学报, 2024, 31(22): 61-66.
[11]	关亚萍, 郑薇亮, 孙丽军, 陈媛, 丁洁莹, 许佳佳. 护士主导的心脏直视术后患者早期四级活动方案的构建[J]. 护理学报, 2024, 31(22): 67-72.
[12]	王熙, 崔献梅. 基于洋葱模型的综合三级甲等医院产科新入职护士独立上岗准入评价指标体系的构建[J]. 护理学报, 2024, 31(21): 32-38.
[13]	丁丽娜, 姚卓娅, 耿军辉, 李漫春, 詹朦, 殷月, 王俊锋, 余丽英. 医院过氧化氢低温等离子体灭菌质量评价指标体系构建[J]. 护理学报, 2024, 31(20): 60-66.
[14]	张国春, 李海云, 褚梁梁, 程雪, 王君芝. 产科护士围产期姑息照护知信行量表的编制及信效度检验[J]. 护理学报, 2024, 31(2): 6-11.
[15]	郭红涛, 张静, 李颖, 甄艺婉. 白血病患儿父母决策冲突现状及影响因素分析[J]. 护理学报, 2024, 31(2): 22-26.

Metrics

Viewed

Full text

Abstract

Cited

Shared