构建中国慢性病终末期老年患者居家临终关怀方案：德尔菲法。
Construction of a Home Hospice Care Program for Older Adults at the End of Life with Chronic Diseases in China: A Delphi Method.
机构信息
Department of Nursing, Jinzhou Medical University, Jinzhou, Liaoning Province, People's Republic of China.
Department of Science and Technology, Jinzhou Medical University, Jinzhou, Liaoning Province, People's Republic of China.
出版信息
Clin Interv Aging. 2024 Oct 29;19:1731-1751. doi: 10.2147/CIA.S477877. eCollection 2024.
PURPOSE
With the increasing aging of the population and the increasing incidence of chronic diseases in China, home hospice care services can meet the desire of the older adult with chronic diseases to receive care and die at home. In order to ensure the real application of hospice in families, the goal of the study was to construct a home hospice care program for the older adult at the end of life with chronic diseases based on Harmony Nursing Theory (composed of three parts: harmony needs assessment, harmony mechanism establishment and interpersonal interaction).
METHODS
Through literature review, a qualitative interview and group discussion, the first draft of a home hospice care program for the older adult at the end of life with chronic diseases based on the harmony nursing theory was developed, which was further revised and finalized by combining the Delphi method of expert correspondence with 19 experts and a pilot study with a home hospice care team.
RESULTS
A total of two rounds of expert correspondence were conducted. In the first round, 21 questionnaires were distributed and 19 were returned, yielding a recovery rate of 90.48%. In the second round, 19 questionnaires were distributed, and 19 questionnaires were collected. The recovery rate was 100%. The authority of the two rounds of expert correspondence was 0.96, and Kendall's coefficient of concordance (W) was 0.268 and 0.310, respectively. After the first round of Delphi expert consultation, 3 items were deleted, and 12 items were revised. In the second round of Delphi expert consultation, two items were revised. The final version of the home hospice program includes 4 first-level items, 20 second-level items, and 59 third-level items.
CONCLUSION
The home hospice care program based on harmony nursing theory is authoritative and scientific and can provide a reference for the practice of home hospice care for the older adult with chronic diseases.
目的
随着中国人口老龄化和慢性病发病率的增加，家庭临终关怀服务可以满足慢性病老年患者在家接受护理和死亡的愿望。为了确保临终关怀在家庭中的真正应用，本研究旨在构建基于和谐护理理论的慢性病终末期老年患者家庭临终关怀方案（由和谐需求评估、和谐机制建立和人际互动三部分组成）。
方法
通过文献回顾、定性访谈和小组讨论，制定了基于和谐护理理论的慢性病终末期老年患者家庭临终关怀方案初稿，结合德尔菲专家函询法和家庭临终关怀团队的试点研究，对该方案进行了修订和定稿。
结果
共进行了两轮专家函询。第一轮发放了 21 份问卷，回收了 19 份，回收率为 90.48%；第二轮发放了 19 份问卷，回收了 19 份，回收率为 100%。两轮专家函询的权威系数分别为 0.96，肯德尔和谐系数（W）分别为 0.268 和 0.310。经过第一轮德尔菲专家咨询，删除了 3 项，修订了 12 项；第二轮德尔菲专家咨询修订了 2 项。家庭临终关怀方案的最终版本包括 4 个一级项目、20 个二级项目和 59 个三级项目。
结论
基于和谐护理理论的家庭临终关怀方案具有权威性和科学性，可为慢性病老年患者家庭临终关怀的实践提供参考。
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