Abstract:

Objective To construct a scientific and standardized self-management program for diabetic foot amputation patients. Methods On the theoretical basis of Bandura theory and Anderson’s behavioral diagnosis model，literature retrieval and semi-structured interview were used to formulate a draft of self-management plan focusing on diabetic foot amputees. From September to November 2022，2 rounds of correspondence were conducted with 31 experts by Delphi method，and indicators at all levels were screened and modified. Results A total of 31 questionnaires were distributed in the 2 rounds of expert consultations，and 31 were recovered. The effective recovery rate of the questionnaires was 100%. The authority coefficient of consulting experts was 0.971；Kendall’s coefficient of harmony was 0.146 and 0.205（P<0.001）. In the second round of consultation，the coefficient of variation of experts was 0~0.15，and all items were 0.25. The final scheme included 3 first-level indicators，23 second-level indicators，and 64 third-level indicators. Conclusion The self-management program with diabetic foot amputation patients as the main position is scientific，targeted and feasible，and can provide bases and guidance for diabetic foot amputation patients to carry out effective and standardized self-management.

Key words: Diabetic Foot, Amputation, Self-Management, Delphi Method, Nursing Care

摘要：

目的 构建科学规范、可供推广的糖尿病足截肢患者自我管理方案。 方法 以班杜拉理论和安德森“行为诊断模型”为理论基础，采用文献检索、半结构访谈的方法，拟订以糖尿病足截肢患者为主位的自我管理方案初稿，2022年9月—10月，采用德尔菲法对31名专家进行2轮函询，对各级指标进行筛选和修改。 结果 2轮函询各发放问卷31份，收回31份，问卷有效回收率均为100%；函询专家权威系数均为0.971；肯德尔和谐系数分别为0.146和0.205（P<0.001），第2轮函询中，专家意见的变异系数为0~0.15，所有条目的变异系数均<0.25，最终形成糖尿病足截肢患者自我管理方案，包括3个一级指标、23个二级指标、64个三级指标。 结论 糖尿病足截肢患者自我管理方案具有较好的科学性、针对性和可行性，能够为糖尿病足截肢患者开展有效规范的自我管理提供依据和指导。

关键词: 糖尿病足, 截肢, 自我管理, 德尔菲法, 护理