Colwell Janice C, Beitz Janice
Ostomy Care Services, University of Chicago Hospitals, IL, USA.
J Wound Ostomy Continence Nurs. 2007 Jan-Feb;34(1):57-69. doi: 10.1097/00152192-200701000-00010.
Validated and reliable stomal and peristomal complication definitions and associated interventions are lacking. Available literature is either narrowly medically focused or only of case study level. The objectives of this study were to establish content validation data for the proposed stomal and peristomal complication definitions and their associated interventions, to obtain the data related to contact with stomal and peristomal complication patients, and to gain insight into the ostomy care process.
A researcher-designed survey was sent to 2900 expert Wound, Ostomy and Continence nurse clinicians via a national mailing to a representative nonrandomized sample of participants who identified that they included ostomy care in their professional practice. In total, 686 nurses returned the survey, a response rate of 24%. The purposive sample was asked to quantify the degree of validity of the survey's stated stomal and peristomal definitions and interventions. Hand-written qualitative comments of the participants were transcribed, analyzed, and themes were derived.
On a scale of 1 to 4, the mean score for all definitions and interventions was 3.64 (SD=0.30). The overall survey's content validity index was .91. Ratings demonstrated high consensus validation on the stomal and peristomal definitions and interventions, with definitions scoring higher. The mean scores and the content validity index results on selected items were slightly lower for interventions, especially stomal interventions. Qualitative analysis of participants' comments about the whole instrument generated 10 themes and associated subthemes related to omitted complications and interventions and general observations about the ostomy care process and the validation research process.
The proposed stomal and peristomal definitions and interventions were rated as generally valid. Further research documenting validation of participants' comments is necessary. Given the findings, additional complications and interventions not identified in the literature were noted and need to be further scrutinized and researched.
目前缺乏经过验证且可靠的造口及造口周围并发症定义以及相关干预措施。现有文献要么在医学方面关注范围狭窄，要么仅处于案例研究水平。本研究的目的是为拟议的造口及造口周围并发症定义及其相关干预措施建立内容效度数据，获取与造口及造口周围并发症患者接触相关的数据，并深入了解造口护理过程。
通过全国性邮件向2900名伤口、造口及失禁护理专家临床医生发送了一份由研究人员设计的调查问卷，这些参与者是通过非随机抽样选取的，他们表示在专业实践中包含造口护理。共有686名护士回复了调查问卷，回复率为24%。该有目的样本被要求对调查问卷中所述的造口及造口周围定义和干预措施的效度程度进行量化。参与者手写的定性评论被转录、分析并提炼出主题。
在1至4的评分量表上，所有定义和干预措施的平均得分为3.64（标准差=0.30）。整个调查问卷的内容效度指数为0.91。评分显示对造口及造口周围定义和干预措施有高度的一致性验证，定义得分更高。干预措施（尤其是造口干预措施）在选定项目上的平均得分和内容效度指数结果略低。对参与者关于整个工具的评论进行定性分析产生了10个主题及相关子主题，涉及遗漏的并发症和干预措施以及对造口护理过程和效度研究过程的总体观察。
拟议的造口及造口周围定义和干预措施被评为总体有效。有必要进行进一步研究以记录对参与者评论的验证。鉴于研究结果，注意到了文献中未识别的其他并发症和干预措施，需要进一步审查和研究。
