临终患者消化道症状辨证施护推荐方案的研究

目的构建临终患者消化道症状辨证施护推荐方案,为规范并推广中医护理技术在临终患者中的应用提供客观依据。方法运用文献研究法,结合临终患者消化道的症状特点,初步构建临终患者消化道症状辨证施护推荐方案,包括临终患者消化道证候、中医护理技术、操作方法、注意事项等。采用德尔菲专家咨询法,通过对16名专家两轮咨询调查,计算专家积极系数,专家权威系数(Cr),对条目的重要性评分采用均数、变异系数(CV)、肯德尔和谐系数W(Kendall's W)进行分析,最终确认临终患者消化道症状辨证施护推荐方案。结果两轮专家咨询有效问卷均为16份,专家积极系数为100%,Cr为0.89;各项指标的CV为0.05~0.27,均小于0.30;各项指标Kendall's W为0.13~0.43(P<0.01)。结论运用文献研究法和德尔菲法构建临终患者消化道症状辨证施护推荐方案,规范中医护理技术在临终患者中的应用,对提高临终患者的生活质量和医疗资源的利用率,均具有一定的实用价值。

Exploration of syndrome differentiation nursing recommendations for end-of-life patients with digestive symptoms

Objective To construct the syndrome differentiation nursing plan for end-of-life patients with digestive symptoms so as to provide an objective evidence for the standardizing and popularizing the traditional Chinese medicine(TCM)nursing operation in end-of-life patients.Methods The initial syndrome differentiation nursing recommendations for end-of-life patients with digestive symptoms were constructed based on literature review combined with digestive symptoms characteristics of end-of-life patients including the digestive syndromes end-of-life patients,TCM nursing operation,operation method and considerations.The method of Delphi expert consultation was used to two rounds of consultation by 16 experts and to calculate the expert positive coefficients and expert authority coefficient(Cr);item importance was analyzed with the mean,variation coefficient(CV)and Kendall's concordance coefficient(Kendall's W)to finally determine the syndrome differentiation nursing plan for end-of-life patients with digestive symptoms.Results Around two rounds of expert consultation,there were 16 valid questionnaires respectively.The expert positive coefficients and Cr were 100%and 0.89 respectively.Variation coefficients of all indexes ranged from 0.05 to 0.27,which were<0.03;the Kendall's W ranged from 0.13 to 0.43(P<0.01).Conclusions The syndrome differentiation nursing plan for end-of-life patients with digestive symptoms based on literature review and Delphi method standardizes the application of TCM nursing operation in end-of-life patients which has practical value on improving the quality of life of end-of-life patients and availability of medical resources.