脑卒中个案管理师准入标准和工作职责方案的构建

目的 构建脑卒中个案管理师准入标准和工作职责,为制订符合中国国情的脑卒中个案管理师人才培养方案和工作标准提供参考依据。方法 基于文献研究、脑卒中患者管理现状调查、专家会议讨论和预咨询,构建准入标准和工作职责初稿;采用德尔菲专家咨询法,对全国8个省市的20名专家进行问卷咨询。 结果 2轮专家咨询的问卷有效回收率分别是95.2%和100.0%。第2轮咨询中,专家权威系数为0.910,准入标准和工作职责的一、二、三级指标专家意见的肯德尔和谐系数分别为0.193、0.155、0.141（P<0.05）和0.445、0.156、0.134（P<0.05）。最终形成的脑卒中个案管理师准入标准包括一级指标3项（基础条件、专业能力、综合能力）,二级指标7项,三级指标17项。工作职责包括一级指标4项（评估、计划、实施、评价）,二级指标17项,三级指标79项。 结论 经专家咨询确定的脑卒中个案管理师准入标准和工作职责方案具有较好的科学性、实用性、可行性和创新性,能为脑卒中个案管理护理实践提供理论依据。

Construction of eligibilities and responsibilities for stroke case managers

Objective To establish eligibilities and responsibilities for stroke case managers,and to provide references for training programs and work standards for stroke case managers in accordance with China’s national conditions. Methods Based on literature research,investigation of status of stroke patients management,expert meeting discussions and pre-consultations,a preliminary draft of eligibilities and responsibilities was constructed. Twenty experts from 8 provinces were consulted by Delphi expert consultation method. Results The effective recovery rates of the two rounds of expert consultations were 95.2% and 100%,respectively. In the second round of consultation,the authoritative coefficient of experts was 0.910,and the coordination coefficients of the first,second and third-level indicators of eligibilities and responsibilities were 0.193,0.155,0.141（P<0.005） and 0.445,0.156 and 0.134（P<0.005）,respectively. The final eligibilities for stroke case managers included three first-level indicators（basic conditions,professional ability,comprehensive ability）,seven second-level indicators and 17 third-level indicators. Responsibilities included four first-level indicators（assessment,planning,implementation,evaluation）,17 second-level indicators and 79 third-level indicators. Conclusion The eligibilities and responsibilities of stroke case managers determined by expert consultations are scientific,practical,feasible and innovative,which can provide theoretical basis for nursing practice of stroke case management.