预防卒中相关性肺炎非人工气道护理方案构建

doi:10.3761/j.issn.0254-1769.2023.01.002

摘要/Abstract

摘要：

目的构建预防卒中相关性肺炎非人工气道护理方案，为有效预防卒中相关性肺炎提供借鉴。方法成立研究小组，在文献研究的基础上结合临床实践经验初步拟订预防卒中相关性肺炎非人工气道护理方案，通过2轮德尔菲专家函询，对方案条目进行修改，确定最终方案。结果 2轮德尔菲专家函询问卷回收率分别为88.24%、100%；专家权威系数为0.940；第2轮专家函询后，各个条目的重要性和可操作性的变异系数分别为0~0.224、0~0.245，肯德尔和谐系数分别为0.139、0.241，差异具有统计学意义（P<0.001）。最终方案包括卒中相关性肺炎风险评估、进食管理、呼吸道管理和口腔卫生管理4个一级条目、16个二级条目、54个三级条目。结论该研究专家积极性和权威程度较高，专家意见协调程度较好，构建的预防卒中相关性肺炎非人工气道护理方案具有可靠性、针对性和可行性。

关键词: 脑卒中, 肺炎, 非人工气道, 预防, 护理, 德尔菲法

Abstract:

Objective In order to construct a non-artificial airway care scheme for the prevention of stroke-associated pneumonia and to provide references for effectively preventing stroke-associated pneumonia. Methods A group was set up to preliminarily formulate a non-artificial airway management program based on literature research and clinical experience. Through 2 rounds of expert consultations，the items were modified and the final scheme was determined. Results The return rates of questionnaires in 2 rounds were 88.24% and 100%，respectively. The expert authority coefficient is 0.940. After the second round of expert consultation，the variation coefficients of importance and feasibility of each item were 0-0.224 and 0-0.245，and the Kendall harmony coefficients were 0.139 and 0.241，respectively，with statistically significant differences（P<0.001）.The final scheme consists of 4 first-level items with risk assessment，dietary management，respiratory management，and oral health management，16 second-level items and 54 third-level items. Conclusion Experts have a high degree of enthusiasm and authority，and their opinions are well coordinated. The non-artificial airway care scheme constructed in this study for the prevention of stroke-associated pneumonia is reliable，specific and practical.

Key words: Stroke, Pneumonia, Non-Manual Airway, Prevention, Nursing Care, Delphi Technique

胡恩慧, 沈小芳, 李红艳, 徐妍妍, 秦学娟. 预防卒中相关性肺炎非人工气道护理方案构建[J]. 中华护理杂志, 2023, 58(1): 15-22.

HU Enhui, SHEN Xiaofang, LI Hongyan, XU Yanyan, QIN Xuejuan. Construction of a non-manual airway care program for the prevention of stroke-associated pneumonia[J]. Chinese Journal of Nursing, 2023, 58(1): 15-22.

图/表 3

表1 专家一般资料（n=15）

Table 1 General data of experts（n=15）

表2 预防卒中相关性肺炎非人工气道护理方案

Table 2 Non-manual airway care options for prevention of stroke-associated pneumonia

表3 痰液黏稠度分级及经口咽部湿化量与频率

Table 3 Classification of sputum viscosity and the amount and frequency of wetting through the oropharynx

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