目的 构建小儿肝移植术后出院随访管理方案,旨在为临床护理工作提供理论依据。方法 2023年10月—2024年1月采用文献检索法、德尔菲专家函询法,筛选指标并确定指标的权重,建立小儿肝移植术后出院随访管理方案。结果 函询专家的积极系数为100%,2轮专家函询的权威系数分别为0.930和0.935,协调系数分别为0.331和0.259。最终形成了8个一级条目、17个二级条目和37个三级条目的小儿肝移植术后出院随访管理方案。结论 基于德尔菲法构建的随访管理方案具备科学的理论基础和较强的实用性,有助于规范小儿肝移植术后出院随访流程,提高护理质量,并改善患儿的术后健康结局,促进其长期康复和生活质量的提升。
Abstract
Objective To construct a discharge follow-up management program for pediatric liver transplantation, and to provide theoretical basis for clinical nursing. Methods Through literature retrieval and Delphi expert consultation from October 2023 to January 2024, indicator were screened; the weight of indicators were determined, then a discharge follow-up management program for pediatric liver transplantation was constructed. Results The positive coefficient of expert consultation was 100%; authority coefficients of the two rounds of consultation were 0.930 and 0.935, and coordination coefficients 0.331 and 0.259, respectively. The final follow-up management program consisting of 8 first-level, 17 second-level, and 37 third-level items was constructed. Conclusion The follow-up management program based on the Delphi method is scientific and practical, helping to standardize post-discharge follow-up process, improve nursing quality, enhance postoperative health outcomes for pediatric patients, and promote their long-term recovery and quality of life.
关键词
肝移植术后 /
出院随访 /
德尔菲法
Key words
liver transplantation /
discharge follow-up program /
Delphi method
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 中华医学会器官移植学分会. 中国肝移植术后并发症诊疗规范(2019版)[J]. 器官移植,2021,12(2):129-133. DOI:10.3969/j.issn.1674-7445.2021.02.002.
[2] 卢芳燕,董丽,刘元,等. 儿童肝移植围手术期护理质量评价指标体系的构建[J]. 中华护理杂志,2022,57(6):666-673. DOI:10.3761/j.issn.0254-1769.2022.06.004.
[3] 黄旭叶,邵冬玲,卢芳燕. 基于循证和德尔菲法构建肝移植术后血糖管理方案[J]. 护理与康复,2023,22(11):1-9. DOI:10.3969/j.issn.1671-9875.2023.11.001.
[4] Quadros J, Piedade C, Lopes MF.Auxiliary liver transplantation for management of acute liver failure in children-systematic review[J]. Transplant Rev (Orlando), 2021,35(4):100631. DOI:10.1016/j.trre.2021.100631.
[5] 魏新哲,孙超,董冲,等. 外周血嗜酸性粒细胞百分比对不同年龄段儿童肝移植术后早期急性排斥反应的预测价值[J]. 临床小儿外科杂志,2022,21(5):420-424. DOI:10.3760/cma.j.cn101785-202111020-005.
[6] 夏强, 刘源. 儿童肝移植的挑战与展望[J]. 中华器官移植杂志, 2024, 45(5):299-302.DOI:10.3760/cma.j.cn421203-20231016-00130.
[7] 吴浩翔,吕子成,侯宇宸,等. 儿童肝移植中他克莫司浓度个体内变异[J]. 外科理论与实践,2022,27(2):145-151. DOI:10.16139/j.1007-9610.2022.02.012.
[8] 黄莹,杨巧玲,张宇,等. 儿童肝移植非计划再入院的影响因素分析及护理对策[J]. 循证护理,2022,8(9):1229-1232. DOI:10.12102/j.issn.2095-8668.2022.09.018.
[9] 高伟. 儿童肝移植的手术技术革新[J]. 器官移植,2022,13(3):296-302. DOI:10.3969/j.issn.1674-7445.2022.03.003.
[10] Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique[J]. J Adv Nurs, 2000,32(4):1008-1015. DOI:10.3969/j.issn.1674-7445.2022.03.003.
[11] 赵诗雨,喻姣花,汪欢,等. 基于循证构建肠内营养护理质量敏感指标体系[J]. 中华护理杂志,2019,54(3):344-349. DOI:10.3761/j.issn.0254-1769.2019.03.004.1.
[12] Mcpherson S, Reese C, Wendler MC. Methodology update: delphi studies[J]. Nurs Res,2018,67(5):404-410.4.
[13] 黄盼盼,程红,张迎红,等.基于4R 危机管理理论构建互联网+护理服务风险管理评价指标体系[J].护理学报,2022, 29(9):16-20.DOI:10.16460/j.issn1008-9969.2022.09.016.
[14] 解晓帅,李雪,张凤莹,等. 肝胆外科肝移植患者营养风险筛查及其营养治疗现状调查分析[J]. 实用器官移植电子杂志,2020,8(1):42-44.DOI:10.3969/j.issn.2095-5332.2020.01.009.
[15] Parry SM, Nydahl P, Needham DM.Implementing early physical rehabilitation and mobilisation in the ICU: institutional, clinician, and patient considerations[J]. Intensive Care Med, 2018,44(4):470-473.DOI:10.1007/s00134-017-4908-8.
基金
湖南省卫生健康委计划项目（D202314049218）
PDF(786 KB)
