晚期心力衰竭患者缓和照护需求评估指标体系的构建

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目的:构建晚期心力衰竭患者缓和照护需求评估指标体系,以期为晚期心力衰竭患者的缓和医疗实施提供评估工具。方法:基于文献分析、质性访谈、专家小组会议初步确定晚期心力衰竭患者缓和医疗评估指标体系初稿,于2020年9—10月邀请15名从事临床心血管病治疗护理、从事缓和医疗领域的相关专家进行2轮专家咨询,综合专家意见、指标满分率和变异系数确定各级评价指标。结果:专家权威系数为0.90,2轮咨询专家的积极系数为75%和100%;2轮函询后的专家意见协调系数均在0.30左右,最终形成包括生理需求、心理需求、社会需求、灵性需求和善终准备需求共5个一级指标、13个二级指标和68个三级指标的晚期心力衰竭患者缓和照护需求评估指标体系。结论:构建的晚期心力衰竭患者缓和照护需求评估指标体系具有较强的科学性、可靠性,可为晚期心力衰竭患者的缓和照护实施提供评估工具。“,”Objective:To construct an index system for evaluating the needs of patients with advanced heart failure for palliative care, so as to provide an evaluation tool for the implementation of palliative care for patients with advanced heart failure.Methods:Based on literature analysis, qualitative interviews, and expert group meetings, the first draft of the palliative medical evaluation index system for patients with advanced heart failure was initially determined. From September to October 2020, 15 experts engaged in clinical cardiovascular disease treatment and nursing, and palliative medicine were invited to conduct two rounds of expert consultation. We combined expert opinions, index full score rate and coefficient of variation to determine evaluation indexes at all levels.Results:The expert authority coefficient was 0.90, and expert positive coefficients of the two rounds of consultation were 75% and 100%.The coordination coefficients of expert opinions after two rounds of consultation were both around 0.30. The final index system for evaluating the needs of patients with advanced heart failure for palliative care included 5 first-level indicators involving physical needs, psychological needs, social needs, spiritual needs, and hospice preparation needs, as well as 13 second-level indicators, 68 third-level indicators.Conclusions:The constructed index system for evaluating the needs of patients with advanced heart failure for palliative care is scientific and reliable, which can provide an evaluation tool for the implementation of palliative care for patients with advanced heart failure.
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