终末期肾病患者延续护理需求评估体系的构建

发布时间：2019-03-03 10:00

【摘要】：目的构建适合我国国情的终末期肾病患者延续护理需求评估体系,并对能够量化的指标进行信效度检验。方法经文献分析、访谈患者,结合临床实践,以奥马哈系统为理论框架来编制终末期肾病患者延续护理需求评估体系,并应用德尔菲法、预调查、指标分析和信效度检验来评估指标的信效度和可靠性。结果(1)初步编制的终末期肾病患者护理评估体系被15名专家进行了2轮函询,专家函询的积极系数分别为88.2%和100%,专家权威系数为0.83,专家意见的总体协调系数分别为0.20和0.53,P值均小于0.01。专家函询后的评估体系包括ABC三部分:A部分为患者基本资料;B部分为患者护理问题评估表,包括生理、认知、心理社会和健康相关行为4项一级指标和30项二级指标;C部分为延续护理需求服务项目表,包括护理需求等级和干预项目2项指标。其条目内容效度指数(I-CVI)为0.8~1.0,全体一致的量表水平效度指数(S-CVI)为0.68,平均水平的S-CVI为0.96。(2)对能够量化的护理问题评估表(B部分)继续进行指标分析和信效度验证,最终得到5项一级指标和21项二级指标,5项一级指标分别被命名为生理、信息实践、心理社会、健康相关行为和照顾资源,所有指标的公因子方差为0.503~0.805,总方差贡献率为66.1%,因子负荷量分别介于0.818~0.834、0.653~0.867、0.632~0.845、0.699~0.837、0.808~0.882,因子总评估表的内部一致性信度(Cronbachα)为0.826,各因子的Cronbachα为0.683、0.910、0.674、0.700和0.755。结论本研究构建的终末期肾病患者延续护理需求评估体系经专家函询、心理学测试后,它能较全面的反映终末期肾病患者延续护理需求特点,符合我国国情和医疗发展水平,能用于同行的延续护理实践与研究。
[Abstract]:Objective to construct a continuous nursing needs assessment system for patients with end-stage kidney disease (ESRD), and to test the reliability and validity of quantifiable indicators. Methods through literature analysis, interview patients, combined with clinical practice, Omaha system as a theoretical framework to develop the end-stage renal disease patients with continuous nursing needs assessment system, and Delphi method, pre-investigation. Index analysis and reliability test were used to evaluate the reliability and reliability of the index. Results (1) two rounds of correspondence were conducted by 15 experts, the positive coefficient of expert correspondence was 88.2% and 100%, and the authority coefficient of expert was 0.83, the results were as follows: (1) the nursing evaluation system of end-stage nephrosis patients was conducted by 15 experts for two rounds of correspondence. The overall coordination coefficients of expert opinions are 0.20 and 0.53, respectively, and the P values are less than 0.01. The evaluation system after expert correspondence includes three parts: part A is the basic data of patients, part B is the evaluation form of patients' nursing problems, including 4 first-degree indexes of physiological, cognitive, psycho-social and health-related behaviors and 30 second-level indicators; Part C is a list of continuing nursing needs service items, including nursing demand grade and intervention item 2 indicators. The item content validity index (I-CVI) was 0.8-1.0, and the consistent scale-level validity index (S-CVI) was 0.68. The average level of S-CVI was 0.96. (2) the index analysis and reliability and validity of the quantifiable nursing assessment form (part B) were carried out and five first-level indexes and 21 second-level indexes were obtained. The five first-level indexes were named as physiology, information practice, psycho-society, health-related behavior and care resources. The common factor variance of all indexes was 0.503 and 0.805, and the contribution rate of total variance was 66.1%. The factor loads were 0.818 脳 0.834, 0.653 / 0.867, 0.632 / 0.845, 0.699 / 0.837, 0.808 / 0.882, respectively. The internal consistency reliability (Cronbach 伪) was 0.826, and the Cronbach 伪 of each factor was 0.683, 0.910, 0.674, 0.700 and 0.7552.The internal consistency reliability (Cronbach 伪) of each factor was 0.683,0.910, 0.674, 0.700 and 0.755, respectively. Conclusion the evaluation system of continuous nursing needs of patients with end-stage kidney disease, after expert correspondence and psychological test, can comprehensively reflect the characteristics of continuing nursing needs of patients with end-stage kidney disease, which is in line with the national conditions and the level of medical development in China. It can be used to continue nursing practice and research.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.5

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