Abstract:

Objective To construct a postoperative lung infection preventive care program for lung cancer patients and carry out preliminary validation，so as to provide a reference basis that can be used in clinical practice. Methods Literature analysis was carried out to search domestic and international databases，guideline networks，and association websites，with a search timeframe of January 2011 to December 2021，to obtain relevant evidence，to construct a preliminary draft of a preventive care program for postoperative lung infections in patients with lung cancer，and to use the Delphi method of correspondence with experts from Guangdong Province，Henan Province，and Sichuan Province，September-December 2022，to determine the content of the program. Correspondence to determine the content of the program. In November-December 2023，15 thoracic surgery nurses and 15 lung cancer patients in a tertiary hospital in Shantou City were selected for the initial application of the program and evaluated the effectiveness of the program through the nurses’ clinical significance，applicability，feasibility，and patient satisfaction. Results A total of 21 experts completed 2 rounds of correspondence. 95.65% and 95.45% of questionnaires were returned in the 2 rounds of correspondence；the authority coefficients of the experts were 0.941 and 0.948；the Kendall’s harmony coefficients were 0.176 and 0.310；the coefficients of variation for each item in the 2nd round of correspondence were 0.04~0.25. The final draft of the program included 10 aspects and 37 measures，such as teamwork，health education，risk assessment，rehabilitation training，fluid management，oral manage-ment，airway management，nutritional management，pain management，line management，and other 10 areas with 37 measures. After the initial application of the program，100% of the nurses thought that the program was meaningful，87% of the nurses thought that the program was clinically applicable and feasible，and 100% of the patients indicated that they were satisfied with the program，of which 80% were very satisfied. Conclusion The constructed nursing program for preventing postoperative lung infection in lung cancer patients is scientific，relevant and feasible，and can provide references for clinical health care personnel to develop measures for preventing postoperative lung infection in lung cancer patients.

Key words: Lung Cancer, Lung Infections, Delphi Technology, Nursing Program Construction, Preventive Management

摘要：

目的 构建肺癌患者术后肺部感染预防护理方案并进行初步验证，为临床护理提供参考依据。 方法 采用文献分析法，检索国内外数据库、指南网、协会网站，检索时限为2011年1月至2021年12月，获取相关证据，构建肺癌患者术后肺部感染预防护理方案初稿，并采用德尔菲专家函询法，于2022年9月—12月对广东省、河南省、四川省的专家进行函询，确定方案终稿。2023年11月—12月，选取汕头市某三级甲等医院15名胸外科护士及15例肺癌患者进行方案的初步应用，并通过护士对方案的临床意义、适用性、可行性评价以及患者满意度等评价方案效果。 结果 共21名专家完成2轮函询。2轮函询中，问卷回收率分别为95.65%、95.45%；专家的权威系数分别为0.941、0.948；肯德尔和谐系数分别为0.176、0.310；第2轮函询中，各条目的变异系数为0.04~0.25。方案终稿包括团队合作、健康教育、风险评估、康复训练、液体管理、口腔管理、气道管理、营养管理、疼痛管理、管路管理等10个方面，37项措施。方案初步应用后，100%的护士认为该方案很有意义，87%的护士认为该方案很具有临床适用性、可行性，100%的患者表示对该方案满意，其中80%的患者表示很满意。 结论 构建的肺癌患者术后肺部感染预防护理方案具有科学性、针对性和可行性，可为临床医护人员制订预防肺癌患者术后肺部感染措施提供参考。

关键词: 肺癌, 肺部感染, 德尔菲技术, 护理方案构建, 预防管理