【摘要】：目的構(gòu)建適合我國(guó)國(guó)情的終末期腎病患者延續(xù)護(hù)理需求評(píng)估體系,并對(duì)能夠量化的指標(biāo)進(jìn)行信效度檢驗(yàn)。方法經(jīng)文獻(xiàn)分析、訪談患者,結(jié)合臨床實(shí)踐,以?shī)W馬哈系統(tǒng)為理論框架來(lái)編制終末期腎病患者延續(xù)護(hù)理需求評(píng)估體系,并應(yīng)用德?tīng)柗品�、預(yù)調(diào)查、指標(biāo)分析和信效度檢驗(yàn)來(lái)評(píng)估指標(biāo)的信效度和可靠性。結(jié)果(1)初步編制的終末期腎病患者護(hù)理評(píng)估體系被15名專(zhuān)家進(jìn)行了2輪函詢(xún),專(zhuān)家函詢(xún)的積極系數(shù)分別為88.2%和100%,專(zhuān)家權(quán)威系數(shù)為0.83,專(zhuān)家意見(jiàn)的總體協(xié)調(diào)系數(shù)分別為0.20和0.53,P值均小于0.01。專(zhuān)家函詢(xún)后的評(píng)估體系包括ABC三部分:A部分為患者基本資料;B部分為患者護(hù)理問(wèn)題評(píng)估表,包括生理、認(rèn)知、心理社會(huì)和健康相關(guān)行為4項(xiàng)一級(jí)指標(biāo)和30項(xiàng)二級(jí)指標(biāo);C部分為延續(xù)護(hù)理需求服務(wù)項(xiàng)目表,包括護(hù)理需求等級(jí)和干預(yù)項(xiàng)目2項(xiàng)指標(biāo)。其條目?jī)?nèi)容效度指數(shù)(I-CVI)為0.8~1.0,全體一致的量表水平效度指數(shù)(S-CVI)為0.68,平均水平的S-CVI為0.96。(2)對(duì)能夠量化的護(hù)理問(wèn)題評(píng)估表(B部分)繼續(xù)進(jìn)行指標(biāo)分析和信效度驗(yàn)證,最終得到5項(xiàng)一級(jí)指標(biāo)和21項(xiàng)二級(jí)指標(biāo),5項(xiàng)一級(jí)指標(biāo)分別被命名為生理、信息實(shí)踐、心理社會(huì)、健康相關(guān)行為和照顧資源,所有指標(biāo)的公因子方差為0.503~0.805,總方差貢獻(xiàn)率為66.1%,因子負(fù)荷量分別介于0.818~0.834、0.653~0.867、0.632~0.845、0.699~0.837、0.808~0.882,因子總評(píng)估表的內(nèi)部一致性信度(Cronbachα)為0.826,各因子的Cronbachα為0.683、0.910、0.674、0.700和0.755。結(jié)論本研究構(gòu)建的終末期腎病患者延續(xù)護(hù)理需求評(píng)估體系經(jīng)專(zhuān)家函詢(xún)、心理學(xué)測(cè)試后,它能較全面的反映終末期腎病患者延續(xù)護(hù)理需求特點(diǎn),符合我國(guó)國(guó)情和醫(yī)療發(fā)展水平,能用于同行的延續(xù)護(hù)理實(shí)踐與研究。
[Abstract]:Objective to construct a continuous nursing needs assessment system for patients with end-stage kidney disease (ESRD), and to test the reliability and validity of quantifiable indicators. Methods through literature analysis, interview patients, combined with clinical practice, Omaha system as a theoretical framework to develop the end-stage renal disease patients with continuous nursing needs assessment system, and Delphi method, pre-investigation. Index analysis and reliability test were used to evaluate the reliability and reliability of the index. Results (1) two rounds of correspondence were conducted by 15 experts, the positive coefficient of expert correspondence was 88.2% and 100%, and the authority coefficient of expert was 0.83, the results were as follows: (1) the nursing evaluation system of end-stage nephrosis patients was conducted by 15 experts for two rounds of correspondence. The overall coordination coefficients of expert opinions are 0.20 and 0.53, respectively, and the P values are less than 0.01. The evaluation system after expert correspondence includes three parts: part A is the basic data of patients, part B is the evaluation form of patients' nursing problems, including 4 first-degree indexes of physiological, cognitive, psycho-social and health-related behaviors and 30 second-level indicators; Part C is a list of continuing nursing needs service items, including nursing demand grade and intervention item 2 indicators. The item content validity index (I-CVI) was 0.8-1.0, and the consistent scale-level validity index (S-CVI) was 0.68. The average level of S-CVI was 0.96. (2) the index analysis and reliability and validity of the quantifiable nursing assessment form (part B) were carried out and five first-level indexes and 21 second-level indexes were obtained. The five first-level indexes were named as physiology, information practice, psycho-society, health-related behavior and care resources. The common factor variance of all indexes was 0.503 and 0.805, and the contribution rate of total variance was 66.1%. The factor loads were 0.818 脳 0.834, 0.653 / 0.867, 0.632 / 0.845, 0.699 / 0.837, 0.808 / 0.882, respectively. The internal consistency reliability (Cronbach 偽) was 0.826, and the Cronbach 偽 of each factor was 0.683, 0.910, 0.674, 0.700 and 0.7552.The internal consistency reliability (Cronbach 偽) of each factor was 0.683,0.910, 0.674, 0.700 and 0.755, respectively. Conclusion the evaluation system of continuous nursing needs of patients with end-stage kidney disease, after expert correspondence and psychological test, can comprehensively reflect the characteristics of continuing nursing needs of patients with end-stage kidney disease, which is in line with the national conditions and the level of medical development in China. It can be used to continue nursing practice and research.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R473.5

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