基于移动健康应用程序的食管癌术后管饲患者家庭肠内营养远程管理方案的构建OA
Development of a mobile application-based telemanagement protocol for home enteral nutrition in post-esophagectomy patients with tube feeding
目的 构建基于移动健康应用程序的食管癌术后携营养管出院,需继续进行管饲肠内营养支持患者的家庭肠内营养远程管理方案.方法 以健康信念模型为理论指导,采用文献研究、专题小组会议构建管理方案初稿,采用德尔菲法进行专家函询确定管理方案.结果 共进行3轮专家函询,前2轮问卷有效回收率均为100%,第3轮问卷有效回收率为93%;专家权威系数为0.939;可操作条目Kendall协调系数分别为0.122、0.203、0.209(P<0.05).最终形成感知威胁(易感性/严重性)、感知收益、减少制约因素、提示行动线索、提升自我效能5个干预方向;预住院至术前、术后1d至出院、出院至出院90d,包含43条干预内容的方案.结论 基于移动健康应用程序的食管癌术后管饲患者家庭肠内营养远程管理方案构建过程严谨,为患者应对家庭肠内营养管理挑战提供潜在的解决方案.
Objective To develop a mobile application-based remote management protocol for home enteral nutrition in post-esopha-gectomy patients discharged with an indwelling feeding tube and requiring ongoing tube-feeding support.Methods Guided by the health belief model(HBM),a preliminary protocol was developed through literature review and expert meeting.Delphi method was em-ployed for expert consultation to finalize the protocol.Results Three rounds of expert consultation were conducted.The valid re-sponse rates for the first two rounds were both 100%,while that for the third round was 93%.The expert authority coefficient was 0.939,and the Kendall·s coefficients of concordance for the actionable items were 0.122,0.203,and 0.209 respectively(P<0.05).Five inter-vention directions were identified:perceived threat(susceptibility/severity),perceived benefits,reducing constraints,prompting action cues,and enhancing self-efficacy.The intervention plan spanned three time periods:pre-admission to preoperative,postoperative day 1 to discharge,and discharge to 90 days after discharge,comprising a total of 43 intervention items.Conclusion The development of mobile application-based remote management protocol for home enteral nutrition in post-esophagectomy tube-fed patients was system-atic and rigorous,which provides a potential solution to help patients address challenges in home enteral nutrition.
陈涛;董高悦;钱冬兰;智晓旭;张柳柳;嵇艳
南京医科大学附属肿瘤医院(江苏省肿瘤医院)胸外科,江苏 南京 210009南京医科大学附属肿瘤医院(江苏省肿瘤医院)胸外科,江苏 南京 210009南京医科大学附属肿瘤医院(江苏省肿瘤医院)胸外科,江苏 南京 210009南京医科大学附属肿瘤医院(江苏省肿瘤医院)护理部,江苏 南京 210009南京医科大学附属肿瘤医院(江苏省肿瘤医院)护理部,江苏 南京 210009南京医科大学 护理学院,江苏 南京 211166
医药卫生
食管癌营养管理健康信念模型科普视频远程干预移动健康应用程序德尔菲法
esophageal cancernutritional managementhealth belief modelpopular science videoremote interventionmobile health applicationDelphi method
《护理学报》 2026 (7)
6-13,8
江苏省医院管理创新研究项目(JSYGY-3-2021-284)南京医科大学附属肿瘤医院/江苏省肿瘤医院临床科技攀登计划-护理研究专项(ZH202302)
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