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癌症发热成年患者两种体温测量方法的等效性研究

Equivalence Study of Two Temperature-Measurement Methods in Febrile Adult Patients With Cancer.

作者信息

Mason Tina M, Boubekri Abdelbaki, Lalau Jennifer, Patterson Amy, Hartranft Susan R, Sutton Steven K

机构信息

Cancer Center and Research Institute, University of South Florida, Tampa.

H. Lee Moffitt Cancer Center and Research Institute.

出版信息

Oncol Nurs Forum. 2017 Mar 1;44(2):E82-E87. doi: 10.1188/17.ONF.E82-E87.

Abstract

PURPOSE/OBJECTIVES: To assess equivalence of temperatures taken via temporal artery and oral methods in febrile inpatients with cancer.
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DESIGN: Repeated measures equivalence design.
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SETTING: 24-bed hematology-oncology unit and 36-bed blood and marrow transplantation unit at H. Lee Moffitt Cancer Center and Research Institute, a National Cancer Institute-designated comprehensive cancer center in Tampa, Florida.
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SAMPLE: Convenience sample of 58 febrile inpatients using 60 temperature measurements.
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METHODS

Two instruments were used.

MAIN RESEARCH VARIABLES: Temperature readings from oral and temporal artery measurements.
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FINDINGS: A two one-sided test (TOST) technique with a delta of 0.2ºF was performed to assess equivalence of the oral and temporal artery measures. Within each team member, the oral and temporal artery measures were assessed using the TOST technique. The hypothesis of equivalence was rejected for all three team members. 
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CONCLUSIONS: The use of the Exergen TAT-5000 for temperature measurement as a noninvasive alternate to the oral method for febrile adult patients in the hematology-oncology population was not supported. 
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IMPLICATIONS FOR NURSING

The Exergen TAT-5000 is not a reliable instrument for detecting fevers in the hematology-oncology patient population because the temporal artery measures were not equivalent to oral measures, and considerable variation occurred for the three nurses. Alternative methods for accurate temperature collection need to be investigated, particularly for febrile, neutropenic patients who cannot tolerate the oral probe.

摘要

目的/目标:评估癌症发热住院患者经颞动脉和口腔测量体温的等效性。

设计

重复测量等效性设计。

地点

佛罗里达州坦帕市的H. Lee Moffitt癌症中心和研究所的一个拥有24张床位的血液肿瘤科病房以及一个拥有36张床位的血液和骨髓移植病房,该研究所是美国国立癌症研究所指定的综合癌症中心。

样本

采用便利抽样法选取58例发热住院患者,进行60次体温测量。

方法

使用了两种仪器。

主要研究变量

口腔和颞动脉测量的体温读数。

结果

采用差值为0.2华氏度的双侧单侧检验(TOST)技术评估口腔和颞动脉测量的等效性。在每个团队成员中,使用TOST技术评估口腔和颞动脉测量值。所有三名团队成员的等效性假设均被拒绝。

结论

在血液肿瘤患者群体中,对于发热成年患者,使用Exergen TAT - 5000作为口腔测量法的非侵入性替代方法来测量体温未得到支持。

对护理的启示

Exergen TAT - 5000在检测血液肿瘤患者群体发热方面不是一种可靠的仪器,因为颞动脉测量值与口腔测量值不等效,且三名护士测量结果差异较大。需要研究准确测量体温的替代方法,特别是对于不能耐受口腔探头的发热、中性粒细胞减少患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febc/7771286/688297dc8f42/nihms-1655105-f0001.jpg

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