多學科協作下糖尿病腎病病人護理質量評價體系的構建與應用研究

Construction and application of nursing quality evaluation system for diabetic nephropathy patients under multidisciplinary collaboration

XU Yun，DAI Jing，ZHANG Yiting，JI XingyaoSuzhou Municipal Hospital，Jiangsu 215000 ChinaCorresponding Author JI Xingyao，E-mail：13915531084@163.com

Abstract Objective：To establish a multidisciplinary nursing quality evaluation system for patients with diabetes nephropathy and apply it in clinical practice.Methods：Through literature search，we screened the literature related to nursing quality evaluation of diabetes nephropathy patients，read the full text of the literature to select the evaluation indicators of nursing quality of diabetes nephropathy patients，and after Delphi method expert letter evaluation，revised the evaluation indicators of nursing quality of diabetes nephropathy patients，finally formed the evaluation system of nursing quality of diabetes nephropathy patients under multidisciplinary cooperation.Since March 202 the nursing quality evaluation system for diabetes nephropathy patients under multidisciplinary cooperation had been applied.Previously，the conventional nursing mode was used.The diabetes nephropathy patients admitted from January 2021 to February 2022 were set as the control group，and the diabetes nephropathy patients admitted from March 2022 to April 2023 were set as the observation group，with 53 cases each.Compared the blood glucose control effect，quality of life，and nursing satisfaction between two groups of patients.Results：The results of Delphi correspondence showed that the recovery rate of the two rounds of correspondence was 100%，the authority of the correspondence experts was 0.845，0.85 and the Kendall concordance coefficient of the two rounds of correspondence was 0.372 （Plt;0.001），0.428（Plt;0.001），respectively.The nursing quality evaluation system for diabetes nephropathy patients under the multidisciplinary cooperation finally formed included 3 first level indicators，8 second level indicators，38 third level indicators，and the coefficient of variation of indicators was rang 0.086 to 0.170.The application results of the evaluation system showed that before intervention，there were no statistically significant differences in fasting blood glucose，2 h postprandial blood glucose，glycated hemoglobin，incidence of hypoglycemia，patient quality of life specific scale evaluation and nursing satisfaction evaluation between the two groups （Pgt;0.05）.After intervention，the incidence of fasting blood glucose，2 h postprandial blood glucose，glycated hemoglobin and hypoglycemia in observation group was lower than that in control group;the quality of life specific scale of observation group was higher than that of control group;the nursing satisfaction of patients in observation group was higher than that in control group.The differences were statistically significant （Plt;0.05）.Conclusion：The evaluation system of nursing quality for patients with diabetes nephropathy under multidisciplinary cooperation is scientific and reliable.The application of this evaluation system in clinical practice can continuously evaluate and improve the quality of nursing，strengthen the effect of nursing intervention，help improve the rehabilitation life of patients，and improve nursing satisfaction.

Keywords diabetic nephropathy;multidisciplinary collaboration;nursing quality;evaluation system;Delphi method

摘要 目的：構建多學科協作下糖尿病腎病病人護理質量評價體系，并在臨床中進行應用。方法：通過文獻檢索篩選糖尿病腎病病人護理質量評價相關文獻，閱讀文獻全文以遴選糖尿病腎病病人護理質量評價指標，并經德爾菲法專家函詢評價、修訂糖尿病腎病病人護理質量評價指標，最終形成多學科協作下糖尿病腎病病人護理質量評價體系。自2022年3月起應用多學科協作下糖尿病腎病病人護理質量評價體系，2021年1月—2022年2月收治的采用常規護理模式的糖尿病腎病病人設為對照組，2022年3月—2023年4月收治的糖尿病腎病病人設為觀察組，各53例。比較兩組病人血糖控制效果、生活質量及護理滿意度。結果：德爾菲法函詢結果顯示，兩輪函詢回收率均為100%，函詢專家權威程度分別為0.845，0.85 兩輪函詢肯德爾和諧系數分別為0.372（Plt;0.001）、0.428（Plt;0.001），最終形成的多學科協作下糖尿病腎病病人護理質量評價體系包含一級指標3個、二級指標8個、三級指標38個，指標變異系數為0.086～0.170。評價體系應用結果顯示，干預前，兩組病人空腹血糖、餐后2 h血糖、糖化血紅蛋白、低血糖發生率、病人生存質量特異性量表評分、護理滿意度評分比較，差異無統計學意義（Pgt;0.05）；干預后，觀察組病人空腹血糖、餐后2 h血糖、糖化血紅蛋白、低血糖發生率均小于對照組；且病人生存質量特異性量表評分高于對照組；病人護理滿意度評分高于對照組，差異均有統計學意義（Plt;0.05）。結論：多學科協作下糖尿病腎病病人護理質量評價體系科學性、可靠性表現較好，該評價體系在臨床中的應用，能持續評價、改進護理質量，強化護理干預效果，有助于改善病人康復生活，并提高護理滿意度。……