Abstract:

Objective This consensus aims to provide evidence-based guidance for clinical nurses in educating and supporting cancer patients to conduct scientific and effective self-management of radiation-induced skin injury （RISI）. Methods The consensus was developed in strict accordance with the Standard Guideline Development Process of World Health Organization. Evidence was identified through literature retrieval，quality appraisal，and data extraction to formulate the initial draft. From July to October 2025，21 experts in clinical nursing，clinical medicine，and nursing management from oncology，radiotherapy，and wound/ostomy care participated in 2 rounds of Delphi consultation，and 15 experts attended an expert panel meeting to finalize the consensus. Results The effective response rates for the 2 rounds of expert consultation were both 100%. The experts’ authority coefficients were 0.922 and 0.924；the importance ratings were（4.54±0.34） and （4.62±0.39） points；the average coefficients of variation were 0.175 and 0.162；the Kendall’s W values were 0.174 and 0.168（all P<0.001）. A total of 354 comments were collected across 2 rounds. Based on expert consultation and panel discussion，the content was revised，and the final consensus includes risk factor identification，self-assessment and active reporting，daily care，selection and application of dressings，pharmacological prevention，and commonly used management methods. Conclusion This consensus provides scientific evidence for nurses to guide cancer patients in the self-management of radiation-induced skin injury and lays a foundation for subsequent research.

Key words: Cancer, Radiation-Induced Skin Injury, Self-Management, Expert Consensus, Nursing Care

摘要：

目的 编制肿瘤患者放射性皮肤损伤自我管理指导专家共识（以下简称“共识”），旨在为护士指导肿瘤患者对放射性皮肤损伤进行科学、有效的自我管理提供依据。方法 严格遵循世界卫生组织标准版指南制订流程，经文献检索、质量评价、证据提取形成“共识”初稿。2025年7—10月，邀请21名肿瘤、放疗、伤口/造口相关领域的临床护理、临床医疗或护理管理专家进行2轮函询，并组织15名专家进行专家论证，形成“共识”终稿。结果 2轮函询的有效问卷回收率均为100%，专家的权威系数分别为0.922、0.924，条目的重要性评分分别为（4.54±0.34）（4.62±0.39）分，平均变异系数分别为0.175、0.162，肯德尔和谐系数分别为0.174、0.168（均P<0.001），2轮函询共收集354条修改意见。根据函询及论证专家建议修订“共识”内容，最终形成的“共识”包括风险因素识别、自我评估及主动报告、日常护理、敷料的选择及使用、药物预防、常用处理方法等内容。结论 该“共识”可为护士指导肿瘤患者进行放射性皮肤损伤的自我管理提供科学依据，并为后续相关研究的开展奠定基础。

关键词: 肿瘤, 放射性皮肤损伤, 自我管理, 专家共识, 护理