Nursing Career Pathway Center, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Division of Behavioral Sciences Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Nurs Open. 2021 Mar;8(2):646-655. doi: 10.1002/nop2.669. Epub 2020 Nov 2.
We examined accuracy of nurses' clinical judgement of graft-versus-host-disease (GVHD) symptoms and related factors using Common Terminology Criteria for Adverse Events (CTCAE) for patients who developed chronic cutaneous GVHD after haematopoietic stem cell transplants.
Cross-sectional design using nationwide survey.
A questionnaire survey based on Tanner's clinical judgement model to assess patients with chronic cutaneous GVHD using CTCAE was used. Free-text descriptions and statistical analyses of relationship between correct responses and demographic data were performed.
The rate of correct responses for main symptoms of skin GVHD was < 50%; there was no statistical significance between correct responses and demographic data, knowledge about GVHD and collaborative practice with physicians. The accuracy of cutaneous GVHD clinical judgements was not directly related to nurses' background. Educational opportunities that reinforce nurses' abilities to reflect on knowledge and experiences to interpret patient symptoms are essential for improving accuracy of clinical judgement.
我们使用不良事件通用术语标准(CTCAE)检查了移植后发生慢性皮肤移植物抗宿主病(GVHD)的患者中护士对 GVHD 症状及其相关因素的临床判断准确性,并探讨了相关因素。
使用全国性调查的横断面设计。
采用基于 Tanner 临床判断模型的问卷调查,使用 CTCAE 评估患有慢性皮肤 GVHD 的患者。对正确回答与人口统计学数据、GVHD 知识和与医生合作实践之间的关系进行了自由文本描述和统计分析。
GVHD 主要皮肤症状的正确回答率<50%;正确回答与人口统计学数据、GVHD 知识和与医生的合作实践之间没有统计学意义。皮肤 GVHD 临床判断的准确性与护士的背景没有直接关系。教育机会对于增强护士解释患者症状的能力至关重要,这对于提高临床判断的准确性至关重要。