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妇科手术后多学科康復建议:专家间的改良 Delphi 法。

Multidisciplinary convalescence recommendations after gynaecological surgery: a modified Delphi method among experts.

机构信息

Department of Obstetrics and Gynaecology, AMC UMCG UWV VUmc, Amsterdam, the Netherlands.

出版信息

BJOG. 2011 Dec;118(13):1557-67. doi: 10.1111/j.1471-0528.2011.03091.x. Epub 2011 Sep 7.

Abstract

OBJECTIVE

To generate structured detailed uniform convalescence recommendations after gynaecological surgery by a modified Delphi method amongst experts and a representative group of physicians.

DESIGN

Modified Delphi study.

SETTING

Expert physicians recruited by their respective medical boards and employed at different hospitals, doctor's surgeries and healthcare services.

POPULATION

Twelve experts (five gynaecologists, two general practitioners [GPs] and five occupational physicians [OPs]) and a representative sample of 63 medical doctors.

METHODS

Multidisciplinary detailed recommendations for graded resumption of relevant activities after uncomplicated hysterectomy (laparoscopic supracervical, total laparoscopic/laparoscopic-assisted, vaginal and abdominal hysterectomies) and laparoscopic adnexal surgery were developed. Recommendations were based on a literature review and a modified Delphi procedure among 12 experts, recruited in collaboration with the participating medical boards of gynaecologists, GPs and OPs.

MAIN OUTCOME MEASURES

A multidisciplinary consensus of at least 67% on the relevant detailed convalescence recommendations in relation to hysterectomy and laparoscopic adnexal surgery.

RESULTS

Out of initially 65 activities, the expert panel judged 38 activities relevant for convalescence recommendations. Consensus for all activities was achieved after four Delphi rounds and two group discussions. The recommendations were judged as feasible by a representative sample of 26 gynaecologists, 19 GPs and 18 OPs.

CONCLUSIONS

Consensus between gynaecologists, GPs and OPs was achieved on all relevant convalescence recommendations regarding hysterectomy (abdominal, vaginal and laparoscopic) and laparoscopic adnexal surgery.

摘要

目的

通过改良 Delphi 法在专家和代表性医师群体中生成妇科手术后结构化详细统一的康复建议。

设计

改良 Delphi 研究。

地点

通过各自的医疗委员会招募的专家医师,在不同的医院、医生诊所和医疗保健服务机构工作。

人群

12 名专家(5 名妇科医生、2 名全科医生和 5 名职业医生)和 63 名医生的代表性样本。

方法

为腹腔镜下经宫颈子宫切除术(腹腔镜下子宫全切除术、腹腔镜辅助/完全腹腔镜子宫切除术、经阴道子宫切除术和经腹子宫切除术)和腹腔镜附件手术制定了相关活动分级恢复的多学科详细康复建议。建议基于文献综述和与参与的妇科、全科医生和职业医生的医疗委员会合作进行的改良 Delphi 程序。

主要观察指标

在妇科和腹腔镜附件手术的康复建议方面,至少有 67%的专家达成多学科共识。

结果

在最初的 65 项活动中,专家小组判断 38 项活动与康复建议相关。经过四轮 Delphi 调查和两次小组讨论,所有活动都达成了共识。这些建议得到了 26 名妇科医生、19 名全科医生和 18 名职业医生的代表性样本的评估,认为这些建议具有可行性。

结论

妇科医生、全科医生和职业医生在与腹腔镜下附件手术和经腹、经阴道和腹腔镜子宫切除术相关的所有康复建议方面达成了共识。

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