宫颈癌术后患者随访清单的制订及应用

doi:10.3761/j.issn.0254-1769.2023.24.007

摘要/Abstract

摘要：

目的制订科学、规范的宫颈癌术后患者随访清单，为随访工作提供科学的工具支持。方法基于患者需求，通过文献回顾、半结构式访谈及小组讨论制订宫颈癌术后患者随访清单初稿；于2022年10月—12月采用德尔菲法对专家进行2轮函询，筛选专家意见并修改完善清单，形成随访清单终稿。采用便利抽样法，于2023年2月—3月选取辽宁省某三级甲等医院的8名护士和15例宫颈癌术后患者作为研究对象，由护士采用术后随访清单对患者进行电话随访，对制订的随访清单进行评价。结果 2轮函询专家的积极系数分别为88.89%和100%；专家权威系数分别为0.88、0.89。第1轮专家函询一、二、三级指标的肯德尔和谐系数分别为0.177、0.245、0.179；第2轮分别为0.170、0.118、0.107（P<0.05）。最终形成的宫颈癌术后患者随访清单包括生理与日常生活支持、信息支持、心理支持和社会支持4项一级指标、12项二级指标及45项三级指标。护患双方均认为随访清单内容全面，具有较强的专业性和临床实用性。结论宫颈癌术后患者随访清单结构合理，内容较全面，且具有可靠性、专科性和实用性，可为宫颈癌术后患者出院后的随访提供科学、规范的工具支持。

关键词: 宫颈癌, 随访, 德尔菲法, 清单, 延续性护理, 肿瘤护理

Abstract:

Objective To formulate a scientific and standardized follow-up checklist for postoperative patients with cervical cancer，and provide a scientific tool to support the follow-up work. Methods The first draft of the follow-up checklist was constructed through literature review and semi-structured interviews，and the final draft of the follow-up checklist was formed by conducting 2 rounds of correspondence with experts using the Delphi method from October to December 2022，screening experts’ opinions and revising and improving the checklist. The convenience sampling method was adopted to select 8 nurses and 15 patients with cervical cancer after surgery from a tertiary A hospital in Liaoning Province from February to March 2023 as the research subjects. The nurses made telephone follow-up visits to the patients with the postoperative follow-up list and evaluated the follow-up list.Results The positive coefficients of the experts in the 2 rounds of correspondence were 88.89% and 100%，respectively；the authoritative coefficients were 0.88 and 0.89，respectively；the Kendal harmony coefficient of the primary，secondary and tertiary indicators were 0.177，0.245 and 0.179 in the first round and 0.170，0.118 and 0.107 in the second round，respectively（P<0.05）. The final follow-up checklist for postoperative patients with cervical cancer included 4 primary indicators of physical and daily life support，information support，psychological support，and social support，12 secondary indicators，and 45 tertiary indicators. Both nurses and patients believed that the follow-up list was comprehensive with strong professional and clinical practicability. Conclusion The follow-up checklist is reasonable in structure，comprehensive in content，and reliable，specialized and practical，which can provide a scientific and standardized tool to support post-discharge follow-up of patients with cervical cancer.

Key words: Cervical Cancer, Follow Up, Delphi Method, Checklist, Continuity of Care, Oncologic Nursing

孙悦, 王志敏, 胡颖, 葛静玲. 宫颈癌术后患者随访清单的制订及应用[J]. 中华护理杂志, 2023, 58(24): 2989-2995.

SUN Yue, WANG Zhimin, HU Ying, GE Jingling. Development and application of a follow-up checklist for postoperative patients with cervical cancer[J]. Chinese Journal of Nursing, 2023, 58(24): 2989-2995.

图/表 1

参考文献 20

[1]	Miller KD, Fidler-Benaoudia M, Keegan TH, et al. Cancer statistics for adolescents and young adults,2020[J]. CA Cancer J Clin, 2020, 70(6):443-459. DOI URL
[2]	Galica J, Saunders S, Romkey-Sinasac C, et al. The needs of gynecological cancer survivors at the end of primary treatment:a scoping review and proposed model to guide clinical discussions[J]. Patient Educ Couns, 2022, 105(7):1761-1782. DOI URL
[3]	Reed N, Balega J, Barwick T, et al. British Gynaecological Can-cer Society(BGCS) cervical cancer guidelines:recommendations for practice[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 256:433-465. DOI URL
[4]	Sun Y, Ma YL, Li QR, et al. Supportive care needs of women with gynaecological cancer:a systematic review and synthesis of qualitative studies[J]. J Adv Nurs, 2023, 79(8):2784-2801. DOI URL
[5]	赵英姿, 王洪庆, 陈芳. 延续性家庭护理干预对宫颈癌术后患者的影响[J]. 齐鲁护理杂志, 2022, 28(14):27-29.
	Zhao YZ, Wang HQ, Chen F. Effect of continued family nursing intervention in postoperative patients with cervical cancer[J]. J Qilu Nurs, 2022, 28(14):27-29.
[6]	张亚红, 杨涛. 延续性护理对宫颈癌患者广泛子宫切除后生活质量的影响观察[J]. 贵州医药, 2021, 45(9):1490-1491.
	Zhang YH, Yang T. Effect of continuous nursing on quality of life of patients with cervical cancer after extensive hysterectomy[J]. Guizhou Med J, 2021, 45(9):1490-1491.
[7]	冯翔, 田俊, 王斌全, 等. 护士主导的喉癌术后患者随访清单的制订[J]. 中华护理杂志, 2018, 53(8):956-961.
	Feng X, Tian J, Wang BQ, et al. Development of follow-up checklist for postoperative patients with laryngeal cancer[J]. Chin J Nurs, 2018, 53(8):956-961.
[8]	柯淞淋, 冷虹瑶, 唐语蔓, 等. 出院新生儿母乳喂养随访清单的构建[J]. 中华护理杂志, 2022, 57(16):1962-1969.
	Ke SL, Leng HY, Tang YM, et al. Construction of a breast-feeding follow-up checklist for discharged newborns[J]. Chin J Nurs, 2022, 57(16):1962-1969.
[9]	周梦珂, 李惠萍, 张珊珊, 等. 基于患者参与的乳腺癌术后随访清单的构建[J]. 中国护理管理, 2022, 22(7):1056-1060.
	Zhou MK, Li HP, Zhang SS, et al. Development of follow-up checklist for postoperative patients with breast cancer based on patients participation[J]. Chin Nurs Manag, 2022, 22(7):1056-1060.
[10]	German Guideline Program in Oncology. Evidence-based gui-deline diagnosis,treatment, and follow-up in patients with cervical carcinoma[EB/OL].(2022-03-11)[2022-08-28]. https://register.awmf.org/assets/guidelines/032_D_Krebsgesellschaft/032-033OLeng_S3_GGPO_Cervical_Carcinoma_2022-08.pdf.
[11]	Bonevski B, Sanson-Fisher R, Girgis A, et al. Evaluation of an instrument to assess the needs of patients with cancer[J]. Cancer, 2000, 88(1):217-225. DOI PMID
[12]	Flottorp SA, Oxman AD, Krause J, et al. A checklist for iden-tifying determinants of practice:a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice[J]. Implement Sci, 2013, 8:35. DOI PMID
[13]	Powell C. The Delphi technique:myths and realities[J]. J Adv Nurs, 2003, 41(4):376-382. DOI URL
[14]	张榆. 宫颈癌患者支持性照护方案的构建及初步应用[D]. 重庆: 重庆医科大学, 2022.
	Zhang Y. Construction and preliminary application of suppor-tive care scheme for cervical cancer patients[D]. Chongqing: Chongqing Medical University, 2022.
[15]	刘冬玲, 王莎, 原小艳. 症状管理理论的姑息性护理在宫颈癌晚期住院患者中的应用[J]. 齐鲁护理杂志, 2022, 28(18):36-39.
	Liu DL, Wang S, Yuan XY. Application of palliative care of symptom management theory in hospitalized patients with advanced cervical cancer[J]. J Qilu Nurs, 2022, 28(18):36-39.
[16]	Ma’rifah AR, Afiyanti Y, Huda MH, et al. Effectiveness of psychoeducation intervention among women with gynecological cancer:a systematic review and meta-analysis of randomized controlled trials[J]. Support Care Cancer, 2022, 30(10):8271-8285. DOI
[17]	Afiyanti Y, Milanti A, Rosdiana M, et al. Deficient health care services as barriers to meet care needs of gynecological cancer survivors in Indonesia:a qualitative inquiry[J]. Semin Oncol Nurs, 2021, 37(5):151206. DOI URL
[18]	Printz C. Psychological stress is associated with a higher risk of cervical cancer mortality[J]. Cancer, 2020, 126(2):240-241. DOI PMID
[19]	Maguire R, Kotronoulas G, Simpson M, et al. A systematic review of the supportive care needs of women living with and beyond cervical cancer[J]. Gynecol Oncol, 2015, 136(3):478-490. DOI PMID
[20]	Lopez AJ, Butow PN, Philp S, et al. Age-related supportive care needs of women with gynaecological cancer:a qualitative ex-ploration[J]. Eur J Cancer Care (Engl), 2019, 28(4):e13070.