以质量求发展，以服务铸品牌

护理学报 ›› 2019, Vol. 26 ›› Issue (10): 1-6.doi: 10.16460/j.issn1008-9969.2019.10.001

• 研究生园地 •    下一篇

甲状腺癌术后内分泌治疗患者远程居家照护方案的构建

王晶晶1, 梁爱华1, 齐小芬2, 张会敏3, 徐艳1, 孟红艳1   

  1. 1.新乡医学院第三临床学院,河南 新乡 453000;
    2.新乡医学院第一附属医院,河南 新乡 453100;
    3.新乡医学院护理学院,河南 新乡 453003
  • 收稿日期:2019-02-18 发布日期:2020-07-17
  • 作者简介:王晶晶（1981-）,女,河南新乡人,本科学历,主管护师,硕士研究生在读。
  • 基金资助:
    河南省教育厅人文社会科学研究项目（2017-ZZJH-439）

Tele-homecare Program for Thyroid Cancer Patients with Postoperative Endocrine Treatment

WANG Jing-jing1, LIANG Ai-hua1, QI Xiao-fen2, ZHANG Hui-min3, XU Yan1, MENG Hong-yan1   

  1. 1. The Third Clinical College of Xinxiang Medical University, Xinxiang 453000, China;
    2. The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China;
    3. School of Nursing, Xinxiang Medical University, Xinxiang 453003, China
  • Received:2019-02-18 Published:2020-07-17

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摘要： 目的 构建甲状腺癌术后内分泌治疗患者远程居家照护方案。方法 通过纵向研究探求甲状腺癌术后内分泌治疗患者需求发生的变化规律,基于文献回顾、纵向需求调查及专家会议构建方案初稿,采用德尔菲法对15名专家进行2轮专家咨询,构建甲状腺癌术后内分泌治疗患者远程居家照护方案。结果 2轮专家积极系数分别为94%和100%;专家权威系数分别为0.847和0.860。第2轮咨询中专家意见的协调系数为0.294（P<0.001）。最终形成纵向需求为导向多学科协作的个体化远程照护方案,其中标准化护理剂量包括一级指标4项,二级指标14项,三级指标53项。结论 本研究构建的方案经检验,专家咨询意见集中,结果科学可靠,能为开展甲状腺癌术后内分泌治疗患者的远程居家照护实践提供依据。

关键词: 甲状腺肿瘤, 远程医疗, 居家照护, 德尔菲技术

Abstract: Objective To construct a tele-homecare program for thyroid cancer patients with postoperative endocrine treatment. Methods Longitudinal study was conducted to explore the changing rule of the demand of thyroid cancer patients with postoperative endocrine treatment. The draft of the programe was developed after literature review, longitudinal need survey and expert meeting. Delphi method was used to conduct two rounds of expert consultation in 15 experts then the final version was constructed. Results The positive coefficients of experts in the two rounds of consultation were 94% and 100% respectively, and the authoritative coefficients were 0.847 and 0.860, respectively. The coordination coefficient of expert advice in the second round of consultation was 0.294 (P<0.001). Finally, an individualized, longitudinal demand-oriented and multi-professional team collaborated telehomecare programe was formed, of which standardized nursing dosage included 4 first-level, 14 second-level and 53 third-level indicators. Conclusion Being scientific and reliable, the developed programe can be used as a basis for the practice of tele-homecare for thyroid cancer patients with postoperative endocrine treatment.

Key words: thyroid cancer, telemedicine, home care, Delphi technique

中图分类号: 

  • R473.2
[1] Siegel R L, Miller K D, Jemal A. Cancer Statistics,2015[J].CA Cancer J Clin,2015,65(1):5-29.DOI:10.3322/caac.21254.
[2] 陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2018,27(1):1-14.DOI:10.11735/j.issn.1004-0242.2018.01.A001.
[3] Haugen B R.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What Is New and What has Changed?[J].Cancer,2017,123(3):372-381.DOI:10.1002/cncr.30360.
[4] Shea K, Chamoff B.Telehomecare Communication and Self-care in Chronic Conditions:Moving toward a Shared Understanding[J]. Worldviews Evid Based Nurs, 2012,9(2):109-116.DOI:10.1111/j.1741-6787.2012.00242.x.
[5] Cruz J, Brooks D, Marques A.Home Telemonitoring Effectiveness in COPD: A Systematic Review[J].Int J Clin Pract,2014,68(3):369-378.DOI:10.1111/ijcp.12345.
[6] Koru G, Alhuwail D, Topaz M, et al.Investigating the Challenges and Opportunities in Home Care to Facilitate Effective Information Technology Adoption[J].J Am Med Dir Assoc, 2016,17(1):53-58.DOI:10.1016/j.jamda.2015.10.008.
[7] 殷悦楚楚,戴作雷,刘云,等.移动医疗的现状与发展[J].智慧健康,2016,2(10):57-60.
[8] 胡竹芳,万承贤,徐璐,等.运用微信对强直性脊柱炎出院患者行延续护理的效果[J].中华护理杂志,2015,50(2):175-178.DOI:10.3761/j.issn.0254-1769.2015.02.011.
[9] 陶品月,黄惠桥.移动医疗App在慢性病患者健康管理中的应用进展[J].护理学报, 2016, 23(19):22-25.DOI:10.16460/j.issn1008-9969.2016.19.022.
[10] 徐海萍,王水,孙茹萍,等.移动互联网技术在乳腺癌患者术后康复个案管理中的应用研究[J].中国护理管理,2017,17(11):1540-1544.DOI:10.3969/j.issn.1672-1756.2017.11.022.
[11] 国务院办公厅.国务院办公厅关于促进“互联网+医疗健康”发展的意见[EB/OL]. (2018-04-28)[2018-04-29].http://www.nhc.gov.cn/bgt/gwywj2/201804/6dc3d903724241efb85c0498813de2b9.shtml.
[12] 付菊芳,刘彦君,付建芳,等.护理剂量的概念及其应用价值[J].中国实用护理杂志,2012,28(19):72-74.DOI:10.3760/cma.j.issn.1672-7088.2012.19.040.
[13] Weaver A, Love S B, Larsen M, et al.A Pilot Study:Dose Adaptation of Capecitabine Using Mobile Phone Toxicity Monitoring-supporting Patients in Their Homes[J].Support Car-e in Cancer,2014,22(10):2677-2685.DOI:10.1007/s00520-014-2224-1.
[14] Nimako K, Lu S K, Ayite B, et al.A Pilot Study of a Novel Home Telemonitoring System for Oncology Patients Receiving Chemotherapy[J]. J Telemed Telecare,2013,19(3):148-152.DOI:10.1177/1357633X13483258.
[15] 医学会内分泌学分会中华,中华医学会外科学分会,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南[J].中国肿瘤临床,2012,39(17):1249-1272.DOI:10.3969/j.issn.1000-8179.2012.17.001.
[16] 胡月,李倩,谭琳,等.基于德尔菲法对护理硕士专业学位研究生临床思维能力评价指标体系的构建[J].护理学报,2018,25(7):1-5.DOI:10.16460/j.issn1008-9969.2018.07.001.
[17] Wilson S, Ramelet A S, Zuiderduyn S.Research Priorities for Nursing Care of Infants, Children and Adolescents: A West Australian Delphi Study[J].J Clin Nurs,2010,19(13-14):1919-1928.DOI:10.1111/j.1365-2702.2009.03025.x.
[18] 彭娟,曹家燕,陈昌连,等.甲状腺癌241例健康教育需求情况调查[J].齐鲁护理杂志,2016,22(21):64-66.DOI:10.3969/j.issn.1006-7256.2016.21.030.
[19] Morley S, Goldfarb M.Support Needs and Survivorship Concerns of Thyroid Cancer Patients[J]. Thyroid, 2015,25(6):649-656.DOI:10.1089/thy.2015.0032.
[20] Segrelles C G,Gómez-Suárez C, Soriano J B,et al.A Home Telehealth Program for Patients with Severe COPD: The PROMETE Study[J]. Respir Med, 2014,108(3):453-462.DOI:10.1016/j.rmed.2013.12.003.
[21] National Institute Cancer | What You Need To Know About Thyroid Cancer[EB/OL]. (2016-12-30)[2017-06-12]. http://www.cancer.gov/cancertopics/types/thyroid.
[22] 汪苗,李远珍,管慧.慢病患者延续护理效果评价指标体系构建[J].中国护理管理, 2017,17(10):1384-1388.DOI:10.3969/j.issn.1672-1756.2017.10.021.
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