支持性心理治疗在急性冠状动脉综合征管理中的应用：德尔菲技术的应用。

Supportive Psychotherapy for Healthcare Professionals in The Management of Acute Coronary Syndrome: The Use of Delphi Technique.

机构信息

Division of Psychosomatic and Palliative, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

出版信息

Acta Med Indones. 2022 Apr;54(2):218-237.

PMID:35818645

Abstract

BACKGROUND

Supportive psychotherapy (SP) may increase the benefit of acute coronary syndrome (ACS) management, but there is no structured SP as a guideline for healthcare professionals. This study aimed to develop structured SP as a guideline for implementing psychotherapy in the management of ACS patients in intensive cardiac care unit (ICCU).

METHODS

This qualitative study used Delphi technique as a modified Delphi method to reach a consensus among experts of structured SP for healthcare professionals in the management of ACS during hospitalized in ICCU. This was developed using self-reflection, observation, and interview of SP implementation in daily psychosomatic practice, gathering literature reviews, doing focus group discussion (FGD) and interview with ACS survivors. During the Delphi rounds, we interviewed 50 informants as source people using valid questionnaires, to proceed a draft of the SP framework and the structured sessions. The SP framework draft and the structured sessions were evaluated and corrected by experts anonymously until the consensus was reached. The validity of the consensus was tested, using Likert psychometric scale to reach an agreement. Cronbach alpha test was used to assess construct validity with SPSS 20.

RESULTS

All of preparations conducted before the Delphi rounds showed that ACS patients had psychosomatic disorders during in ICCU, that required support. SP is very helpful to reduce the negative impact of this disorders.Off 50 informants answered a valid and reliable questionnaire which supports the above statement. The draft was made based on the above process. The development of SP for healthcare professionals of ACS managements was reached in a consensus of expert panelists in the second round of the Delphi with Cronbach alpha of 0.9.

CONCLUSION

Supportive psychotherapy (SP) for healthcare professionals in the management of ACS in ICCU were developed and may be applied in clinical practice and research.

摘要

背景

支持性心理治疗（SP）可能会增加急性冠状动脉综合征（ACS）管理的益处，但目前没有针对医疗保健专业人员的结构化 SP 指南。本研究旨在制定结构化 SP 作为指南，以便在重症心脏监护病房（ICCU）中管理 ACS 患者时实施心理治疗。

方法

本定性研究使用德尔菲技术作为改良德尔菲法，旨在就结构化 SP 达成共识，为在 ICCU 住院的 ACS 患者管理中，为医疗保健专业人员提供结构化 SP。这是通过自我反思、观察和日常身心实践中的 SP 实施访谈、文献综述、进行焦点小组讨论（FGD）和与 ACS 幸存者访谈来实现的。在德尔菲回合中，我们采访了 50 名知情人士作为信息来源，使用有效的问卷，以制定 SP 框架和结构化会议的草案。SP 框架草案和结构化会议由专家匿名评估和纠正，直到达成共识。使用李克特心理计量量表测试共识的有效性，以达成一致。使用 SPSS 20 进行 Cronbach alpha 测试以评估结构有效性。

结果

在德尔菲回合之前进行的所有准备工作都表明，在 ICCU 期间，ACS 患者存在身心障碍，需要支持。SP 非常有助于减轻这些障碍的负面影响。在回答有效且可靠问卷的 50 名信息来源中，支持了上述观点。基于上述过程制定了草案。在第二轮德尔菲法中，专家小组就 ACS 管理中医疗保健专业人员的支持性心理治疗达成共识，Cronbach alpha 为 0.9。