摘要
目的构建基于焦点解决短期治疗(solution-focused brief therapy,SFBT)为框架的团体治疗永久性肠造口患者术后早期心理问题干预方案,以便改善患者生活质量。方法以SFBT理论为框架,通过文献回顾以及临床经验形成永久性肠造口患者术后早期心理问题干预方案条目池。运用德尔菲法,邀请14名从事临床医疗、造口护理、心理护理、社会工作的专家进行两轮函询,最终确立基于SFBT团体治疗永久性肠造口患者术后早期心理问题干预方案。结果两轮专家函询表的有效回收率分别为94.44%和82.35%,两轮专家权威系数(authority coefficient,Cr)均为0.825。第一轮与第二轮各条目的变异系数(coefficient of variation,CV)分别为0.07~0.31与0.00~0.06;两轮专家函询肯德尔和谐系数(W)分别为0.154、0.159(?字2分别为166.395和184.328,均P<0.001);第一轮专家函询干预方案各条目重要性赋值为3.82~4.88,标准差为0.33~1.19,第二轮函询各条目重要性赋值为4.29~5.00,标准差为0.00~0.25。构建的干预方案分为6个维度,27个条目,包括组织建设(6个条目)、目标架构(5个条目)、例外架构(4个条目)、假设解决架构(5个条目)、鼓励(2个条目)和信息提供(5个条目)。结论本研究构建干预方案科学可靠,专家的积极程度、权威程度、协调程度及集中程度均较高,能为临床开展规范化的心理干预工作提供参考。
Objective To formulate an early negative psychological intervention scheme for patients with permanent enterostomy.Methods The solution-focused brief therapy(SFBT)was used as theoretical framework.Literature review and clinical experience were employed to construct an item pool.Then the intervention scheme was determined by 14 experts including clinical specialists,enterostomal therapists,psychological specialist nurses and social workers through two rounds of expert consultation using Delphi Method.Results The response rates of the two rounds of questionnaire were 94.44%and 82.35%.The expert authority coefficients were 0.825 for the two rounds.The variation coefficients of the first and second rounds were 0.07-0.31 and 0.00-0.06,respectively.Kendall coordination coefficients for the two rounds were 0.154 and 0.159,respectively(x2=166.395,184.328,P<0.001).In the first round,the importance rating for each item was 3.82-4.88,with a standard deviation of 0.33-1.19.In the second round,the importance rating for each item was 4.29-5.00, with a standard deviation of 0.00-0.25. The negative psychological intervention scheme for the patients with permanent enterostomy included 27 items in 6 dimensions: there were 6 items in the organisation construction, 5 in the target architecture, 4 in the exception architecture, 5 in the hypothetical solution architecture, 2 in the encouragement and 5 in the information provision. Conclusions Ane early negative psychological intervention scheme for patients with permanent enterostomy is established in this study. The enthusiasm, authority, coordination and centralisation of the experts are all at a higher level for reference.
作者
钟美华
叶芬
冯少兰
郑敏琪
苏茜
Zhong Meihua;Ye Fen;Feng Shaolan;Zheng Minqi;Su Qian(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou,510120;Foshan University,Foshan,528000;School of Nursing,Guangzhou Medical University,Guangzhou,510180,China)
出处
《现代临床护理》
2021年第8期37-44,共8页
Modern Clinical Nursing
基金
广东省医学科研基金项目,项目编号为A2016111。
作者简介
同等贡献/第一作者:钟美华(1976-),女,广东广州人,副主任护师,科护士长,硕士,主要从事外科护理工作;同等贡献/第一作者:叶芬(1990-),女,江西九江人,教师,硕士,主要从事护理教育工作;通信作者:苏茜,副教授、博士,E-mail:282268513@qq.com。
