乳腺癌术后患者快速康复护理敏感质量指标体系的构建

目的 构建一套乳腺癌术后患者快速康复护理敏感质量指标体系,为护理管理者及临床护理人员科学评价乳腺癌术后患者快速康复护理质量提供参考。方法 以Donabedian的“结构-过程-结果”三维质量结构模型为理论框架,采用文献研究、半结构化访谈、德尔菲法和层次分析法,确立乳腺癌术后患者快速康复护理敏感质量指标体系及各指标权重。结果 共进行2轮专家函询,2轮专家函询问卷的有效回收率均为100%,专家权威系数分别为0.861、0.875,专家意见的肯德尔协调系数分别为0.402、0.410,差异有统计学意义（P<0.05）。最终形成包括一级指标3项、二级指标9项、三级指标13项的乳腺癌术后患者快速康复护理敏感质量指标体系。结论 构建的乳腺癌术后患者快速康复护理敏感质量指标体系规范、实用,符合乳腺专科特色,对提高乳腺癌术后患者快速康复护理质量安全、规范其护理质量管理、促进其护理质量持续改进具有重要指导意义。

Construction of Nursing Sensitive Quality Index System for Enhanced Recovery after Surgery of Breast Cancer Patients

Objective To construct a nursing sensitive quality index system for enhanced recovery after surgery (EARS) of breast cancer patients, and to provide reference for nursing managers and clinical nurses to evaluate the nursing quality of EARS of breast cancer patients. Methods Donabedian's structure-process-outcome model was employed as theoretical framework; literature review, semi-structured interview, Delphi method and analytic hierarchy process were used to establish the sensitive quality index system and identify the weight of each index for enhanced recovery after surgery (EARS) of breast cancer patients. Results There were two rounds of expert consultation. The effective recovery rate of two rounds of expert consultation was 100%; expert authority coefficient 0.861 and 0.875, and Kendall coordination coefficient of expert 0.402 and 0.410, respectively, indicating statistical significance (P<0.05). The final nursing sensitive quality index system for EARS of breast cancer patients consisted of 3 first-level,9 second-level and 13 third-level indicators. Conclusion The constructed nursing sensitive quality index system for EARS of breast cancer patients is standardized, practical, and in line with the characteristics of breast specialty. It has important guiding significance for improving the quality and safety of EARS for breast cancer patients, standardizing nursing quality management, and promoting the continuous improvement of nursing quality.