阻塞性睡眠呼吸暂停低通气综合征患者持续气道正压通气治疗管理流程的构建

目的探讨构建OSAHS患者持续气道正压通气(CPAP)治疗的管理流程。方法通过翻译和回译,确定中文版管理流程初稿。2018年1—4月,根据研究目的从苏州、无锡等地区的三级甲等医院、高校机构和医疗机构遴选专家12名,采用德尔菲法对初稿进行3轮专家咨询,最终确立OSAHS患者CPAP治疗管理流程。专家积极程度、权威程度、协调程度、意见集中程度分别采用咨询问卷回收率(%)、专家权威系数、变异系数和肯德尔协调系数、条目的重要性评分表示。结果3轮专家咨询问卷有效回收率均为100%;专家的权威系数为0.871;第1轮、第2轮和第3轮各条目的变异系数分别为0~0.10,0~0.10和0~0.08;肯德尔协调系数分别为0.156,0.170和0.167(χ^2值分别为18.667、20.345和20.000;P<0.05);第1轮咨询各条目重要性均数为4.75~5.00,标准差为0~0.45,第2轮咨询各条目重要性均数为4.75~5.00,标准差为0~0.45,第3轮咨询各条目重要性均数为4.83~5.00,标准差为0~0.39。OSAHS患者CPAP治疗管理流程为期1个月,包括睡眠监测报告的充分解读、CPAP使用初始训练、试验治疗和购买设备、试验治疗总结4个部分。结论在ONE MONTH TRIAL基础上构建的OSAHS患者CPAP治疗管理流程,经专家咨询结果可靠,专家的积极程度、权威程度、集中程度及协调程度均较高,能为临床医护人员规范管理OSAHS患者的CPAP治疗过程提供参考。

Construction of management procedure for continuous positive airway pressure treatment in patients with obstructive sleep apnea-hypopnea syndrome

Objective To construct management procedure for continuous positive airway pressure(CPAP)treatment in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods The first draft of Chinese version of management procedure was formed by translation and back translation.From January to April 2018,according to the research purpose,12 experts were selected from ClassⅢGrade A hospitals,universities and medical institutions in Suzhou,Wuxi and other regions.Delphi method was used to conduct 3 rounds of expert consultation on the first draft,and finally management procedure for CPAP in OSAHS patients was established.The expert's active degree,authoritative degree,coordination degree and opinion concentration degree were expressed by the recovery rate(%)of consultation questionnaires,experts authority coefficient,coefficient of variation and Kendall's W,and the importance score of items.Results The response rate of 3 rounds of consultation questionnaire was 100.00%;the authority of experts coefficient was 0.871;the coefficients of variation of the first,second and third rounds were 0-0.10,0-0.10 and 0-0.08,respectively;the Kendall's W for 3 rounds were 0.156,0.170 and 0.167,respectively(χ^2=18.667,20.345,20.000;P<0.05);in the first round,the average of the importance rating was 4.75-5.00,with a standard deviation of 0-0.45;in the second round,the average of the importance rating was 4.75-5.00,with a standard deviation of 0-0.45;in the third round,the average of the importance rating was 4.83-5.00,with a standard deviation of 0-0.39.The management procedure for CPAP treatment in OSAHS patients lasted for one month,including sufficient explaining of sleep monitoring report,initial training of CPAP use,trial treatment and equipment purchase,and summary of trial treatment.Conclusions The management procedure for CPAP treatment in OSAHS patients based on ONE MONTH TRIAL is reliable after consultation with experts,and the degree of enthusiasm,authority,concentration and coordination of the experts is high so as to provide a reference for clinical staff to regulate the CPAP treatment process of OSAHS patients.