肺癌患者常见免疫相关不良事件居家自我管理模式的构建
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女,硕士在读,学生

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国家自然科学基金青年科学基金项目(72204106)


Construction of a home self-management model for common immune-related adverse events in patients with lung cancer
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    摘要:

    目的 构建肺癌患者常见免疫相关不良事件居家自我管理模式,为提高患者自我管理能力,降低免疫相关不良事件严重程度提供参考。方法 基于社会认知理论,结合文献分析与半结构式访谈结果,形成肺癌患者常见免疫相关不良事件居家自我管理模式初稿;运用德尔菲法,遴选28名专家对模式进行2轮函询,完善并确定最终的管理模式。结果 2轮专家函询问卷回收率分别为93.3%、100%,专家权威系数分别为0.88、0.91;第2轮函询中,各指标重要性变异系数0.04~0.18,肯德尔和谐系数0.380(P<0.05),各指标可行性变异系数0.05~0.21,肯德尔和谐系数0.387(P<0.05);最终形成包含信息支持、免疫相关不良事件监测要点、免疫相关不良事件治疗要点、日常生活指导与随访沟通5项一级指标、18项二级指标、46项三级指标的肺癌患者常见免疫相关不良事件居家自我管理模式。结论 肺癌患者常见免疫相关不良事件居家自我管理模式具有较好的专家认可度和可行性,未来可进一步验证该居家自我管理模式的效果。

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    Objective To construct a home self-management model of common immune-related adverse events (irAEs) in patients with lung cancer, and to provide reference for improving patients′ self-management ability and reducing the severity of irAEs.Methods Based on the Social Cognitive Theory, combined with literature analysis and semi-structured interviews, a preliminary draft of the home self-management model for common irAEs in patients with lung cancer was developed.Using Delphi methods, 28 experts were selected to conduct two rounds of consultation to reach a consensus.Results The effective return rate of the two Delphi expert consultations were 93.3% and 100%, and the expert authority coefficients were 0.88 and 0.91, respectively.In the second round of consultation,the coefficients of variation (CV) for the importance of each indicator ranged from 0.04 to 0.18, and the coefficient of Kendall′s coefficient of concordance (W) was 0.380 (P<0.05).The CV of feasibility of each indicator was 0.05-0.21, and the Kendall′s W was 0.387 (P<0.05).The final home self-management model of common irAEs in patients with lung cancer consisted of 5 first-level indicators information support, irAEs monitoring, irAEs treatment, daily life guidance and follow-up communication, 18 second-level indicators, and 46 third-level indicators.Conclusion The home self-management model of common irAEs in patients with lung cancer has good approval and feasibility by experts, and the effect of the home self-management model can be further verified.

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卢睿琦,杨智慧,缪景霞,徐倩,张立力.肺癌患者常见免疫相关不良事件居家自我管理模式的构建[J].护理学杂志,2025,(9):9-14

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  • 收稿日期:2024-12-03
  • 最后修改日期:2025-02-21
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  • 在线发布日期: 2025-06-05