慢性心力衰竭患者远程照护护理问题评估指标的构建

doi:10.3761/j.issn.0254-1769.2023.02.005

摘要/Abstract

摘要：

目的构建慢性心力衰竭（chronic heart failure，CHF）患者远程照护护理问题评估指标，为CHF患者的远程照护实施提供参考，以促进和完善CHF患者健康支持体系。方法基于文献分析、半结构式访谈提取CHF患者远程照护相关护理问题，通过奥马哈问题分类系统使问题的表达规范化，于2021年5月—9月应用德尔菲法确定CHF患者远程照护护理问题评估指标。结果共开展2轮专家函询，专家权威系数为0.923，2轮函询专家的积极系数分别为73.33%和100%，肯德尔和谐系数分别为0.219、0.247（均P<0.01）。最终确定的CHF患者远程照护护理问题评估指标包含4个一级指标，24个二级指标，58个三级指标。结论构建的CHF患者远程照护护理问题评估指标科学性、实用性较强，可为CHF患者远程照护的实施及健康支持体系的构建提供参考。

关键词: 心力衰竭, 远程护理, 护理评估, 指标体系

Abstract:

Objective To establish an evaluation index system of remote care in patients with chronic heart failure （CHF），in order to provide an evaluation tool of remote care，promote and improve the health support system for patients with CHF. Methods Based on literature analysis and semi-structured interview，nursing evaluation questions related to remote care for patients with CHF were extracted. Omaha question classification system was used to normalize the expression of questions，and finally Delphi method was used from May to Sep 2021 to form the evaluation index system for remote care in patients with CHF. Results The authority coefficient of experts was 0.923；the positive coefficients of experts in 2 rounds were 73.33% and 100%；the coordination coefficients were 0.219 and 0.247，respectively（P<0.01）. The standardized nursing questions evaluation system of remote care for patients with CHF was finally determined as 4 first-level indicators，24 second-level indicators and 58 third-level indicators. Conclusion The evaluation index system of remote care for patients with CHF constructed in this study is scientific，practical and instructional，which is of great significance to promote the implementation of remote care for patients with heart failure and formulation of health support system.

Key words: Heart Failure, Remote Care, Nursing Assessment, Index System

芦秀燕, 迟琨, 郇姗姗, 公冶慧娟, 吴珂, 谢方瑜, 孙秀杰, 梁涛. 慢性心力衰竭患者远程照护护理问题评估指标的构建[J]. 中华护理杂志, 2023, 58(2): 165-170.

LU Xiuyan, CHI Kun, HUAN Shanshan, GONGYE Huijuan, WU Ke, XIE Fangyu, SUN Xiujie, LIANG Tao. Construction of an evaluation index system for remote care in patients with chronic heart failure[J]. Chinese Journal of Nursing, 2023, 58(2): 165-170.

图/表 2

参考文献 25

[1]	Ganz FD, Roeh K, Eid M, et al. The need for palliative and support care services for heart failure patients in the community[J]. Eur J Cardiovasc Nurs, 2020, 20(2):138-146. DOI URL
[2]	王华, 李莹莹, 柴坷, 等. 中国住院心力衰竭患者流行病学及治疗现状[J]. 中华心血管病杂志, 2019, 47(11):865-874. PMID
	Wang H, Li YY, Chai K, et al. Contemporary epidemiology and treatment of hospitalized heart failure patients in real clinical practice in China[J]. Chin J Cardiol, 2019, 47(11):865-874. DOI PMID
[3]	Al-Naher A, Downing J, Scott KA, et al. Factors affecting patient and physician engagement in remote health care for heart failure:systematic review[J]. JMIR Cardio, 2022, 6(1):e33366. DOI URL
[4]	邱小芩, 黄彩献, 傅桂芬, 等. 慢性心力衰竭患者院外健康管理程序的构建及应用[J]. 中华护理杂志, 2022, 57(4):401-407. DOI
	Qiu XQ, Huang CX, Fu GF, et al. Construction and application of APP in out-of-hospital health management for patients with chronic heart failure[J]. Chin J Nurs, 2022, 57(4):401-407. DOI
[5]	邵珂, 王茜, 邱筱婷, 等. 慢性心力衰竭患者护理问题评估指标体系的构建[J]. 护理学报, 2019, 26(18):6-11.
	Shao K, Wang Q, Qiu XT, et al. Development of evaluation index system of nursing problem for patients with chronic heart failure[J]. J Nurs China, 2019, 26(18):6-11.
[6]	Wibring K, Herlitz J, Christensson L, et al. Prehospital factors associated with an acute life-threatening condition in non-traumatic chest pain patients-a systematic review[J]. Int J Cardiol, 2016, 219:373-379. DOI URL
[7]	唐欣芝, 吕小林, 顾则娟, 等. 慢性病护理质量评价指标体系研究现状及启示[J]. 中国卫生质量管理, 2021, 28(9):51-54.
	Tang XZ, Lü XL, Gu ZJ, et al. Research status and enlightenment of chronic disease care quality evaluation index system[J]. Chin Health Qual Manag, 2021, 28(9):51-54.
[8]	Sharpe L, Jones E, Ashton-James CE, et al. Necessary components of psychological treatment in pain management programs:a Delphi study[J]. Eur J Pain, 2020, 24(6):1160-1168. DOI URL
[9]	丁珊妮, 潘红英, 虞雪琴, 等. 神经系统疾病标准化护理评估术语的构建[J]. 中华护理杂志, 2018, 53(8):962-966.
	Ding SN, Pan HY, Yu XQ, et al. Establishment of the standardized neurological nursing assessment terminology system[J]. Chin J Nurs, 2018, 53(8):962-966.
[10]	董丽丽, 梁涛. 晚期心力衰竭患者缓和照护需求评估指标体系的构建[J]. 中华现代护理杂志, 2021, 27(12):1586-1591.
	Dong LL, Liang T. Construction of an index system for evaluating the needs of patients with advanced heart failure for palliative care[J]. Chin J Mod Nurs, 2021, 27(12):1586-1591.
[11]	司龙妹, 张佩英, 刘瑾, 等. 三级甲等医院造口专科护理门诊建设标准指标体系的构建[J]. 中国护理管理, 2021, 21(8):1163-1168.
	Si LM, Zhang PY, Liu J, et al. Construction of a standard for nurse-led ostomy clinics in the tertiary hospital in China[J]. Chin Nurs Manag, 2021, 21(8):1163-1168.
[12]	Zhao QF, Wang J, Nicholas S, et al. Health-related quality of life and health service use among multimorbid middle-aged and older-aged adults in China:a cross-sectional study in Shandong Province[J]. Int J Environ Res Public Health, 2020, 17(24):E9261.
[13]	Osenenko KM, Kuti E, Deighton AM, et al. Burden of hospitalization for heart failure in the United States:a systematic literature review[J]. J Manag Care Spec Pharm, 2022, 28(2):157-167.
[14]	Barrett M, Boyne J, Brandts J, et al. Artificial intelligence supported patient self-care in chronic heart failure:a paradigm shift from reactive to predictive,preventive and personalised care[J]. EPMA J, 2019, 10(4):445-464. DOI URL
[15]	王华, 梁延春. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10):760-789.
	Wang H, Liang YC. Chinese guidelines for the diagnosis and treatment of heart failure 2018[J]. Chin J Cardiol, 2018, 46(10):760-789.
[16]	Son YJ, Choi J, Lee HJ. Effectiveness of nurse-led heart failure self-care education on health outcomes of heart failure patients:a systematic review and meta-analysis[J]. Int J Environ Res Public Health, 2020, 17(18):6559. DOI URL
[17]	Suthershinii G, Tan WA, Lee ARYB, et al. Behavioral interventions for the patient-caregiver unit in patients with chronic heart failure:a systematic review of caregiver outcomes[J]. J Multidiscip Healthc, 2022, 15:921-939. DOI PMID
[18]	Khodneva Y, Goyal P, Levitan EB, et al. Depressive symptoms and incident hospitalization for heart failure:findings from the REGARDS study[J]. J Am Heart Assoc, 2022, 11(7):e022818. DOI URL
[19]	胡大一. 让“双心医学”服务模式落地:充分重视精神心理问题的医生教育和科普[J]. 中国全科医学, 2019, 22(18):2150-2151. DOI
	Hu DY. Implementation of“double heart medicine” service model:attaching great importance to mental and psychological problems in doctor education and science communication[J]. Chin Gen Pract, 2019, 22(18):2150-2151.
[20]	Cassidy L, Hill L, Fitzsimons D, et al. The impact of psychoeducational interventions on the outcomes of caregivers of patients with heart failure:a systematic review and meta-analysis[J]. Int J Nurs Stud, 2021, 114:103806. DOI URL
[21]	Dadosky A, Overbeck H, Barbetta L, et al. Telemanagement of heart failure patients across the post-acute care continuum[J]. Telemed J E Health, 2018, 24(5):360-366. DOI PMID
[22]	朱辰蕊, 施继红, 黄喆, 等. 理想心血管健康行为与因素与新发心力衰竭的关系[J]. 中华心血管病杂志, 2021, 49(9):905-911. PMID
	Zhu CR, Shi JH, Huang Z, et al. Relationship between the ideal cardiovascular health behaviors and factors and new onset heart failure[J]. Chin J Cardiol, 2021, 49(9):905-911. DOI PMID
[23]	陈华, 熊晓云, 孙兴兰, 等. 心力衰竭患者易损期液体管理方案的构建及应用[J]. 中华护理杂志, 2022, 57(13):1541-1547. DOI
	Chen H, Xiong XY, Sun XL, et al. Construction and application of a volume management program in vulnerable phase for patients with heart failure[J]. Chin J Nurs, 2022, 57(13):1541-1547. DOI
[24]	Rezamand F, Shahnazi H, Hassanzadeh A. Effectiveness of continuous-care model on self-care in patients with heart failure:application of line follow-up[J]. Scand J Caring Sci, 2019, 33(4):940-948. DOI PMID
[25]	宋红霞, 韩梅, 徐继环. 居家老年慢性心力衰竭患者认知与需求的研究[J]. 中国实用护理杂志, 2018, 34(2):103-107.
	Song HX, Han M, Xu JH. Disease recognition and life demands in the elderly patients with chronic heart failure[J]. Chin J Pract Nurs, 2018, 34(2):103-107.

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	20

来源	本网站	其他网站

次数	21	0
比例	100%	0%

摘要

1126

最新录用	在线预览	正式出版

0	0	1126

	来源	本网站

	次数	1126
	比例	100%