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

doi:10.3761/j.issn.0254-1769.2019.10.007

摘要/Abstract

摘要： 目的构建成年急性白血病化疗患者健康教育效果评价指标体系,为临床护理人员评估成年急性白血病化疗患者健康教育效果,开展针对性的健康教育和指导提供依据。方法以知信行理论为指导,通过文献研究、半结构式访谈法、德尔菲法及层次分析法,确定成年急性白血病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轮专家函询的有效问卷回收率分别为80.00%和93.75%,专家判断系数为0.86,专家熟悉程度为0.78,专家权威程度为0.82,构建的成年急性白血病化疗患者健康教育效果评价指标体系包括3个一级指标、16个二级指标和65个三级指标。结论本研究构建的成年急性白血病化疗患者健康教育效果评价指标体系,能够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标准。

关键词: 急性白血病, 化疗, 健康教育, 指标体系, 德尔菲技术

Abstract: Objective To develop the evaluation index system for health education in adult patients with acute leukemia treated by chemotherapy,which can provide references for clinical nurses to evaluate effects of health education and carry out targeted health education and guidance among adult acute leukemia patients with chemotherapy. Methods Guided by Knowledge Attitude Practice Model,through literature research,semi-structured interviews,Delphi method and analytic hierarchy process,the framework of the evaluation index system for health education in adult patients with acute leukemia chemotherapy and the weight value of each evaluation index were constructed. Results The recovery rates for the first and second rounds of the study were 80.00% and 93.75%,respectively. The expert judgment coefficient was 0.86,the degree of expert familiarity was 0.78,and the degree of expert authority was 0.82. Finally,the index system contained 3 first-level indicators,16 second-level indicators,and 65 third-level indicators. Conclusion The evaluation index system for health education in adult patients with acute leukemia treated by chemotherapy can provide unified standard for clinical nurses to conduct comprehensive and efficient health education evaluation.

Key words: Acute Leukemia, Chemotherapy, Health Education, Index System, Delphi Technique

罗如珍, 解文君, 刘玉典, 张晓红, 刘彦慧. 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 Ruzhen, XIE Wenjun, LIU Yudian, ZHANG Xiaohong, LIU Yanhui. Development of evaluation index system for health education among adult acute leukemia patients with chemotherapy[J]. Chinese Journal of Nursing, 2019, 54(10): 1482-1487.

图/表 5

参考文献 18

[1]	Stewart BW, Wild CP . World cancer report 2014[M]. Pairs:International Agency for Research on Cancer, 2014: 703-722.
[2]	Chen BA, Huang ZH, Zhang XP , et al. An epidemiological investigation of leukemia incidence between 2003 and 2007 in Nanjing,China[J]. J Hematol Oncol, 2010,3(1):21.
[3]	Brunet S, Labopin M, Esteve J , et al. Impact of FLT3 internal tandem duplication on the outcome of related and unrelated hematopoietic transplantation for adult acute myeloid leukemia in first remission:a retrospective analysis[J]. J Clin Oncol, 2012,30(7):735-741.
[4]	Bosshard R, O'Reilly K, Ralston S, et al. Systematic reviews of economic burden and health-related quality of life in patients with acute myeloid leukemia[J]. Cancer Treat Rev, 2018,69(9):224-232.
[5]	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.
[6]	Woods D, Winchester K, Towerman A , et al. From the Children's Oncology Group:evidence-based recommendations for PEG-asparaginase nurse monitoring,hypersensitivity reaction management,and patient/family education[J]. J Pediatr Oncol Nurs, 2017,34(6):387-396.
[7]	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.
[8]	Pailler ME, Johnson TM, Kuszczak S , et al. Adjustment to acute leukemia:the impact of social support and marital satisfaction on distress and quality of life among newly diagnosed patients and their caregivers[J]. J Clin Psychol Med Settings, 2016,23(3):298-309.
[9]	徐琳洁 . 急性白血病患者开展个体化健康教育对健康知识、心理状况及满意度的影响[J]. 临床护理杂志, 2014,13(4):27-29.
[10]	Leak Bryant A, Walton AL, Pergolotti M , et al. Perceived benefits and barriers to exercise for recently treated adults with acute leukemia[J]. Oncol Nurs Forum, 2017,44(4):413-420.
[11]	武飒 . 针对性健康教育对白血病化疗患者自护能力及生活质量的影响[J]. 首都食品与医药, 2018,25(470):101.
[12]	莫利波, 詹春霞 . 个体化健康教育在急性白血病护理中的应用效果[J]. 中国城乡企业卫生, 2018,33(12):87-88.
[13]	乔够梅, 张晓丽, 王养民 , 等. 尿路造口患者健康教育效果评价标准的构建[J]. 中华护理杂志, 2014,49(9):1058-1061.
[14]	孙进 . 质性研究导引[M]. 重庆: 重庆大学出版社, 2011: 128.
[15]	Keeney S, Hasson F , McKenna H. Conducting the research using the delphi technique[J]. Nurs Health Res, 2011,32(5):69-83.
[16]	Fuochi G, Foà C . Quality of life,coping strategies,social support and self-efficacy in women after acute myocardial infarction:a mixed methods approach[J]. Scand J Caring Sci, 2018,32(1):98-107.
[17]	Xi S, Li Z, Zhu M , et al. Determinants of self-efficacy and quality of life in Chinese patients with temporary enterostomy:a cross-sectional survey[J]. J Clin Nurs, 2017,26(3/4):477-484.
[18]	黄玲玲, 郭佳, 丁云 , 等 . 文化调适在跨文化健康行为干预中的应用进展[J]. 中华护理杂志, 2017,52(5):613-617.

项目	指标数	肯德尔和谐系数	χ²值	自由度	P 值
一级指标	3	0.325	10.400	2	0.006
二级指标	16	0.272	65.327	15	<0.001
三级指标	83	0.265	368.794	82	<0.001

项目	指标数	肯德尔和谐系数	χ²值	自由度	P 值
一级指标	3	0.325	10.400	2	0.006
二级指标	16	0.272	65.327	15	<0.001
三级指标	83	0.265	368.794	82	<0.001

项目	指标数	肯德尔和谐系数	χ²值	自由度	P 值
一级指标	3	0.410	12.286	2	0.002
二级指标	16	0.301	67.642	15	<0.001
三级指标	65	0.325	340.906	64	<0.001

项目	指标数	肯德尔和谐系数	χ²值	自由度	P 值
一级指标	3	0.410	12.286	2	0.002
二级指标	16	0.301	67.642	15	<0.001
三级指标	65	0.325	340.906	64	<0.001

一级指标	重要性赋值（分,${ \overline {x} \pm s}$）	变异系数	权重	最大特征根	一致性系数
健康知识	4.933±0.258	0.052	0.528	3.054	0.052
健康信念	4.468±0.516	0.115	0.140
健康行为	4.867±0.352	0.072	0.333