ICU患者膈肌功能障碍发生风险评价指标的构建

doi:10.3761/j.issn.0254-1769.2024.11.008

摘要/Abstract

摘要：

目的构建ICU患者膈肌功能障碍发生风险评价指标，为膈肌功能障碍疾病风险评估工具的建立提供参考。方法系统检索中国知网、万方数据库、PubMed、Embase和Web of Science中有关膈肌功能障碍的文献，检索时限从建库至2022年11月11日，基于文献回顾法，讨论确定指标初稿后，于2023年5月—6月使用头脑风暴法，综合10名医疗、护理专家的意见修改指标初稿。于2023年6月—7月通过专家函询及层次分析法，确定ICU患者膈肌功能障碍发生风险评价指标的内容及权重。结果 35名专家完成第1轮函询，34名专家完成第2轮函询。2轮专家函询的有效问卷回收率分别为92.1%、97.1%，专家权威系数分别为0.884、0.904；各级指标的肯德尔和谐系数分别为0.356~0.570、0.369~0.604（均P<0.001）。最终构建的ICU患者膈肌功能障碍发生风险评价指标包括7个一级指标、34个二级指标、34个三级指标。结论该研究构建的ICU患者膈肌功能障碍发生风险评价指标全面、具体，具有较好的科学性，可指导医护人员早期对ICU患者膈肌功能进行评价，为后续膈肌功能的疾病风险评估工具建立提供参考。

关键词: 重症监护病房, 膈肌功能障碍, 风险评估, 指标, 德尔菲技术, 护理

Abstract:

Objective The risk evaluation indicators for the occurrence of diaphragm dysfunction in ICU patients was constructed to provide a reference for the establishment of the disease risk evaluation tools for diaphragm dysfunction. Methods The literature related to diaphragm dysfunction from CNKI，Wanfang Data，PubMed，Embase and Web of Science from the establishment of databases to November 11th，2022 was systematically searched. After the first draft was determined through the literature review method，the first draft of the indicators was revised by brainstorming，with the opinions of 10 medical and nursing experts from May to June 2023. From June to July 2023，the content and weight of risk evaluation indicators of diaphragmatic dysfunction in ICU patients were determined through expert letter inquiry and hierarchical analysis. Results 35 experts completed the first round of letter inquiry，and 34 experts completed the second round of letter inquiry. The recovery rates of the valid questionnaires in the 2 rounds of expert correspondence were 92.1% and 97.1%，respectively，and the expert authority coefficients were 0.884 and 0.904，respectively，and the Kendall harmony coefficients of all indicators were 0.356~0.570 and 0.369~0.604，respectively（all P<0.001）. The final constructed risk evaluation indicators of diaphragm dysfunction in ICU patients includes 7 first-level indicators，34 secondary indicators and 34 tertiary indicators. Conclusion The risk evaluation index of diaphragm dysfunction in ICU patients constructed in this study is comprehensive，specific，scientific and applicable，which can guide medical staff to conduct early risk evaluation of diaphragm function in ICU patients，and provide references for the establishment of disease risk assessment tools for diaphragm function.

Key words: Intensive Care Unit, Diaphragmatic Dysfunction, Risk Assessment, Indicator, Delphi Technique, Nursing Care

白云锋, 陈天超, 柳馨怡, 冯悦颖, 罗红波, 李尊柱, 孙建华, 曹晶, 邓海波, 吴欣娟. ICU患者膈肌功能障碍发生风险评价指标的构建[J]. 中华护理杂志, 2024, 59(11): 1339-1345.

BAI Yunfeng, CHEN Tianchao, LIU Xinyi, FENG Yueying, LUO Hongbo, LI Zunzhu, SUN Jianhua, CAO Jing, DENG Haibo, WU Xinjuan. Construction of risk evaluation indicators for the occurrence of diaphragm dysfunction in ICU patients[J]. Chinese Journal of Nursing, 2024, 59(11): 1339-1345.

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