鼻咽癌放化疗患者健康教育效果评价指标体系的构建

doi:10.3761/j.issn.0254-1769.2022.08.008

摘要/Abstract

摘要：

目的构建鼻咽癌放化疗患者健康教育效果评价指标体系,为护理工作者评价鼻咽癌放化疗患者健康教育效果,开展针对性的健康教育与指导工作提供理论依据。方法 2021年3月—7月,组建多学科研究团队,以知信行理论为基础,通过文献检索、半结构式访谈法、德尔菲专家函询法及层次分析法,确定鼻咽癌放化疗患者健康教育效果评价指标体系及各指标权重。结果 2轮函询的有效问卷回收率分别为85.0%和100%,专家权威程度系数分别为0.932、0.935;2轮函询各级指标的肯德尔和谐系数分别为0.235~0.326、0.302~0.419（P<0.01）。最终构建包括3个一级指标、19个二级指标和73个三级指标的鼻咽癌放化疗患者健康教育效果评价指标体系。结论该研究构建的鼻咽癌放化疗患者健康教育效果评价指标体系,可为临床护理人员进行全面、高效的健康教育效果评价提供统一参考。

关键词: 鼻咽癌, 放化疗, 健康教育, 效果评价指标, 护理管理研究

Abstract:

Objective We aimed to establish an evaluation index system for health education among patients with nasopharyngeal carcinoma（NPC） who are undergoing radio-chemotherapy. As a theoretical basis,this system may be applied by the clinical nurses to carry out targeted health education and guidance among NPC patients undergoing radio-chemotherapy and to evaluate the effect of health education. Methods From March to July 2021,we constituted a structured multidisciplinary research team,including oncologists,nurse specialists,nutritionists,et al,based on the theory of Knowledge-Belief-Practice. Literature review,semi-structured interviews,as well as the Delphi method and Multi-dimensional Analytic Hierarchy Process,were used to establish a framework of the evaluation index system and set weighted value for each evaluation index. Results The response rates of the 2 rounds of expert consultations are 85.0% and 100%.The expert authority coefficients are 0.932 and 0.935,respectively.The total Kendall harmony coefficients of the 2 rounds of expert consultations are 0.235~0.326 and 0.302~0.419（P<0.01）.As a result,we built up an evaluation index system of health education which comprised 3 first-level indexes,19 second-level indexes and 73 third-level indexes for NPC patients undergoing radio-chemotherapy. Conclusion The evaluation index system may provide evidence and a practice tool for clinical nurses in conducting a comprehensive and efficient evaluation of health education among NPC patients undergoing radio-chemotherapy.

Key words: Nasopharyngeal Carcinoma, Radio-Chemotherapy, Health Education, Effect Evaluation Indicators, Nursing Administration Research

卢佳美, 李维, 廖金莲, 黄晓君, 胡凯, 汤秋明, 梁丽敏, 冯燕, 杨桂荣, 杨丽. 鼻咽癌放化疗患者健康教育效果评价指标体系的构建[J]. 中华护理杂志, 2022, 57(8): 942-949.

LU Jiamei, LI Wei, LIAO Jinlian, HUANG Xiaojun, HU Kai, TANG Qiuming, LIANG Limin, FENG Yan, YANG Guirong, YANG Li. Establishment of an evaluation index system for health education among nasopharyngeal carcinoma patients with radio-chemotherapy[J]. Chinese Journal of Nursing, 2022, 57(8): 942-949.

图/表 1

参考文献 29

[1]	瞿申红, 翁敬锦, 韦嘉章.广西地区2010-2020年鼻咽癌防治概况与未来展望[J]. 中国临床新医学, 2020, 13(12):1183-1189.
	Qu SH, Weng JJ, Wei JZ.The overview and future prospects of prevention and treatment of nasopharyngeal carcinoma in Guangxi from 2010 to 2020[J]. Chin J New Clin Med, 2020, 13(12):1183-1189.
[2]	康敏.中国鼻咽癌放射治疗指南(2020版)[J]. 中华肿瘤防治杂志, 2021, 28(3):167-177.
	Kang M.Guidelines for radiotherapy of nasopharyngeal carcinoma in China(2020 edition)[J]. Chin J Cancer Prev Treat, 2021, 28(3):167-177.
[3]	Fang FM, Huang TL, Lin YH, et al. Concurrent chemoradiotherapy by simultaneously integrated boost volumetric-modulated arc therapy for nasopharyngeal carcinoma-toxicity/quality of life and survival[J]. Head Neck, 2019, 41(5):1282-1289. DOI URL
[4]	熊倩. 冠心病健康教育效果评价指标体系的研究[D]. 重庆: 重庆医科大学, 2015.
	Xiong Q. Research on the outcome assessment index system for health education of coronary disease[D]. ChongQing: Chong Qing Medical University, 2015.
[5]	岑洁, 杨丽.鼻咽癌患者健康管理APP的应用效果[J]. 中国护理管理, 2019, 19(11):1695-1701.
	Cen J, Yang L.Application effect of health management APP on patients with nasopharyngeal carcinoma[J]. Chin Nurs Manag, 2019, 19(11):1695-1701.
[6]	Li C, Duan JY.Effect of high-quality nursing intervention on psychological emotion,life quality and nursing satisfaction of patients with nasopharyngeal carcinoma undergoing radiotherapy[J]. Am J Transl Res, 2021, 13(5):4928-4938.
[7]	陈佩娟, 王丽, 贾海娜.基于跨理论模型健康教育对鼻咽癌放疗患者张口功能锻炼行为的影响[J]. 护理学报, 2020, 27(16):70-74.
	Chen PJ, Wang L, Jia HN.Effect of transtheoretical model-based health education on functional exercise for radiation-induced trismus in patients with nasopharyngeal carcinoma[J]. J Nurs China, 2020, 27(16):70-74.
[8]	汪雪梅, 杨冬花, 陈瑜, 等.综合护理干预在提高鼻咽癌病人参与功能锻炼依从性中的作用[J]. 护理研究, 2017, 31(20):2529-2531.
	Wang XM, Yang DH, Chen Y, et al. Role of comprehensive nursing intervention in improving compliance of patients with nasopharyngeal carcinoma in functional exercise[J]. Nurs Res Chin, 2017, 31(20):2529-2531.
[9]	廖婷婷, 杨丽, 王仁生, 等.鼻咽癌患者家庭延续性护理平台的构建与应用研究[J]. 中华护理杂志, 2020, 55(9):1399-1405.
	Liao TT, Yang L, Wang RS, et al. Construction and application of home-based continuous care platform for patients with nasopharyngeal carcinoma[J]. Chin J Nurs, 2020, 55(9):1399-1405.
[10]	薛彩虹. 急性胰腺炎患者健康教育效果评价指标体系的构建[D]. 青岛: 青岛大学, 2017.
	Xue CH. Construction of evaluation index system for health education effect of patients with acute pancreatitis[D]. Qingdao: Qingdao University, 2017.
[11]	骆惠玉, 张风贞, 齐榕, 等.“互联网+”肿瘤患者健康教育方案的构建[J]. 中华护理杂志, 2017, 52(12):1482-1485.
	Luo HY, Zhang FZ, Qi R, et al. The establishment of “internet plus” health education programme for cancer patients[J]. Chin J Nurs, 2017, 52(12):1482-1485.
[12]	胡俊峰, 侯培森. 当代健康教育与健康促进[M]. 北京: 人民卫生出版社, 2005.
	Hu JF, Hou PS. Contemporary health education and health promotion[M]. Beijing: People’s Medical Publishing House, 2005.
[13]	Cleary A, Dowling M.Knowledge and attitudes of mental health professionals in Ireland to the concept of recovery in mental health:a questionnaire survey[J]. J Psychiatr Ment Health Nurs, 2009, 16(6):539-545. DOI URL
[14]	黄敬亨, 邢育健. 健康教育学[M]. 5版. 上海: 复旦大学出版社, 2011.
	Huang JH, Xing YJ. Public health preventive medicine[M]. 5th ed. Shanghai: Fudan Press, 2011.
[15]	赵晓霜, 张葆荣, 张丹, 等.儿童连续血液净化护理质量评价指标体系的构建[J]. 中华护理杂志, 2020, 55(9):1366-1371.
	Zhao XS, Zhang BR, Zhang D, et al. Establishment of quality indicator system for nursing in pediatric continuous blood purification[J]. Chin J Nurs, 2020, 55(9):1366-1371.
[16]	罗如珍, 解文君, 刘玉典, 等.成年急性白血病化疗患者健康教育效果评价指标体系的构建[J]. 中华护理杂志, 2019, 54(10):1482-1487.
	Luo RZ, Xie WJ, Liu YD, et al. Development of evaluation index system for health education among adult acute leukemia patients with chemotherapy[J]. Chin J Nurs, 2019, 54(10):1482-1487.
[17]	郭尔钢, 吴成, 胡国清.鼻咽癌患者病程中的营养状况[J]. 中国肿瘤临床, 2018, 45(10):492-496.
	Guo EG, Wu C, Hu GQ.Nutritional status in patients with nasopharyngeal cancer[J]. Chin J Clin Oncol, 2018, 45(10):492-496.
[18]	吴莹玉, 黄霞, 贾培培, 等.护士工作场所暴力防范培训体系的构建[J]. 中华护理杂志, 2020, 55(4):584-589.
	Wu YY, Huang X, Jia PP, et al. Development of a nurse training indicator system against workplace violence based on behavioral objectives theory[J]. Chin J Nurs, 2020, 55(4):584-589.
[19]	何梦雪, 陆红, 沈南平, 等.儿童血液肿瘤护理质量指标体系的构建[J]. 中华护理杂志, 2018, 53(8):950-955.
	He MX, Lu H, Shen NP, et al. Preliminary establishment of quality indicator system for pediatric hematology and oncology nursing[J]. Chin J Nurs, 2018, 53(8):950-955.
[20]	刘晓辉, 赵庆华, 肖明朝.护理院失能老年人长期照护服务质量评价指标体系的构建[J]. 中华护理杂志, 2019, 54(6):902-907.
	Liu XH, Zhao QH, Xiao MZ.Construction of service quality evaluation index system for long-term care of disabled elderly in nursing home based on Service Quality Gap Model[J]. Chin J Nurs, 2019, 54(6):902-907.
[21]	李晔雄. 肿瘤放射治疗学[M]. 5版. 北京: 中国协和医科大学出版社, 2018.
	Li YX. Radiation oncology[M]. 5th ed. Beijing: China Peking Union Medical University Press, 2018.
[22]	陆丹.鼻咽癌同期放化疗患者生活质量调查[J]. 河南医学研究, 2018, 27(14):2524-2526.
	Lu D.Quality of life in patients with nasopharyngeal carcinoma treated with concurrent chemoradiotherapy[J]. Henan Med Res, 2018, 27(14):2524-2526.
[23]	张树光, 严杰, 孙玉娇, 等.中青年2型糖尿病患者健康饮食行为及影响因素的研究[J]. 中华护理杂志, 2018, 53(7):816-821.
	Zhang SG, Yan J, Sun YJ, et al. The stages and influencing factors of dietary behaviors in young and middle-aged patients with type 2 diabetes[J]. Chin J Nurs, 2018, 53(7):816-821.
[24]	周春雷, 裴楠, 孙健.强化健康教育在糖尿病住院患者中的应用效果[J]. 中国实用医药, 2018, 12(3):176-177.
	Zhou CL, Pei N, Sun J.Application effect of strengthening health education in patients with diabetes[J]. Chin Practi Med, 2018, 12(3):176-177.
[25]	底瑞青, 李星丹.短视频在鼻咽癌放疗患者吞咽困难健康教育中的应用[J]. 中华护理教育, 2020, 17(1):84-88.
	Di RQ, Li XD.The effect of a short video based on internet platform on swallowing function of patients with nasopharyngeal carcinoma by radiotherapy[J]. Chin J Nurs Educ, 2020, 17(1):84-88.
[26]	陈佩娟, 张露, 张春梅, 等.鼻咽癌放疗患者自我管理效能感对张口功能锻炼依从性的影响研究[J]. 中华护理杂志, 2016, 51(9):1049-1053.
	Chen PJ, Zhang L, Zhang CM, et al. Effects of self-care self-efficacy of patients with nasopharyngeal carcinoma after radiotherapy on mouth opening training compliance[J]. Chin J Nurs, 2016, 51(9):1049-1053.
[27]	中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会肿瘤康复与姑息治疗专业委员会, 等.鼻咽癌营养治疗专家共识[J]. 肿瘤代谢与营养电子杂志, 2018, 5(1):30-32.
	Chinese Anti-Cancer Association, Chinese Society for Oncological Nutrition and Supportive Care,the Committee of Rehabilitation and Palliative Care, et al. Expert consensus on nutritional therapy for patients with nasopharyngeal career[J]. Electron J Metab Nutr Cancer, 2018, 5(1):30-32.
[28]	中华医学会放射肿瘤治疗学分会.放疗营养规范化管理专家共识[J]. 中华放射肿瘤学杂志, 2020, 29(5):324-331.
	Branch of Radiation Oncology of Chinese Medical Association.Expert consensus on standardized management of radiothe-rapy nutrition[J]. Chin J Radiat Oncol, 2020, 29(5):324-331.
[29]	孙建华, 郭海凌, 孙丹丹, 等.重症患者谵妄评估的现状调查及影响因素分析[J]. 中华护理杂志, 2018, 53(1):17-21.
	Sun JH, Guo HL, Sun DD, et al. Current status and influencing factors of application of the confusion assessment method for the intensive care unit(CAM-ICU)[J]. Chin J Nurs, 2018, 53(1):17-21.

编辑推荐 0

Metrics

阅读次数

全文

HTML			PDF

最新录用	在线预览	正式出版	最新录用	在线预览	正式出版
0	0	1	0	0	12

来源	本网站	其他网站

次数	13	0
比例	100%	0%

摘要

690

最新录用	在线预览	正式出版

0	0	690

	来源	本网站

	次数	690
	比例	100%