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《迈向对护士支持住院患者自我管理的概念化理解——一项改良德尔菲研究》

'Towards a conceptualization of nurses' support of hospitalised patients' self-management-A modified Delphi study'.

机构信息

Martini Hospital, Groningen, The Netherlands.

Julius Centre for Health Sciences and Primary Care, Nursing Science, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands.

出版信息

J Clin Nurs. 2024 Nov;33(11):4327-4341. doi: 10.1111/jocn.17066. Epub 2024 Mar 3.

Abstract

AIM

To determine patients', nurses' and researchers' opinions on the appropriateness and completeness of the proposed conceptualization of nurses' support of hospitalised patients' self-management.

DESIGN

A modified Delphi study.

METHODS

We conducted a two-round Delphi survey. The panel group consisted of patients, nurses and researchers. The conceptualization of nurses' support of hospitalised patients' self-management presented in the first Delphi round was based on previous research, including a scoping review of the literature. Data was analysed between both rounds and after the second round. Results are reported in accordance with the guidance on Conducting and Reporting Delphi Studies (CREDES).

RESULTS

In the first round all activities of the proposed conceptualization were considered appropriate to support the patients' self-management. Panel members' comments led to the textual adjustment of 19 activities, the development of 15 new activities, and three general questions related to self-management support during hospitalisation. In the second round the modified and the newly added activities were also deemed appropriate. The clarification statements raised in the first Delphi round were accepted, although questions remained about the wording of the activities and about what is and what is not self-management support.

CONCLUSION

After textual adjustments and the addition of some activities, the proposed conceptualization of nurses' support in patients' self-management while hospitalised have been considered appropriate and complete. Nevertheless, questions about the scope of this concept still remains. The results provide a starting point for further discussion and the development of self-management programs aimed at the hospitalised patient.

IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: The results can be considered as a starting point for practice to discuss the concept of nurses' support for hospitalised patients' self-management and develop, implement and research self-management programs specific for their patient population.

REPORTING METHOD

Results are reported in accordance with the guidance on Conducting and Reporting Delphi Studies (CREDES).

PATIENT OR PUBLIC CONTRIBUTION

Patients were involved as expert panellist in this Delphi study. Impact statement What problem did the study address? Self-management support during hospitalisation is understudied, which undermines the development of evidence-based interventions. What were the main findings? A panel, consisting of patients, nurses and researchers, agreed on the appropriateness of a conceptualization of nurses' support of inpatients' self-management, and identified some points for discussion, mainly related to the boundaries of the concept self-management. Where and on whom will the research have an impact? This study is crucial for generating conceptual understanding of how nurses support patients' self-management during hospitalisation. This is necessary for policy, clinical practice, education, and research on this topic.

摘要

目的

确定患者、护士和研究人员对所提出的护士支持住院患者自我管理概念的适当性和完整性的看法。

设计

改良 Delphi 研究。

方法

我们进行了两轮 Delphi 调查。专家小组由患者、护士和研究人员组成。第一轮 Delphi 调查中提出的护士支持住院患者自我管理的概念是基于先前的研究,包括文献综述。两轮之间以及第二轮之后对数据进行了分析。结果按照进行和报告 Delphi 研究的指南(CREDES)进行报告。

结果

在第一轮中,所提出概念化的所有活动都被认为是支持患者自我管理的适当活动。小组成员的意见导致对 19 项活动进行了文本调整,开发了 15 项新活动,并提出了与住院期间自我管理支持相关的三个一般性问题。在第二轮中,修改后的和新添加的活动也被认为是适当的。第一轮 Delphi 调查中提出的澄清声明得到了认可,尽管仍然存在关于活动措辞以及什么是和什么不是自我管理支持的问题。

结论

经过文本调整和添加一些活动后,所提出的护士支持住院患者自我管理的概念被认为是适当和完整的。然而,关于这个概念的范围仍然存在问题。结果为进一步讨论和开发针对住院患者的自我管理计划提供了起点。

对专业和/或患者护理的意义:结果可以作为实践的起点,以讨论护士对住院患者自我管理的支持概念,并为特定患者群体制定、实施和研究自我管理计划。

报告方法

结果按照进行和报告 Delphi 研究的指南(CREDES)进行报告。

患者或公众的贡献

患者作为专家小组成员参与了这项 Delphi 研究。

影响说明

研究解决了什么问题?

住院期间的自我管理支持研究不足,这阻碍了基于证据的干预措施的发展。

主要发现是什么?

由患者、护士和研究人员组成的专家小组同意护士支持住院患者自我管理的概念是适当的,并确定了一些需要讨论的要点,主要涉及自我管理概念的界限。

这项研究将在哪里以及对谁产生影响?

这项研究对于生成关于护士如何在住院期间支持患者自我管理的概念理解至关重要。这对于该主题的政策、临床实践、教育和研究都是必要的。

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