1.Department of Pediatric Surgery, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi Zhuang Autonomous Region, Baise 533000, China;
2.Department of Nursing, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi Zhuang Autonomous Region, Baise 533000, China; 3.School of Nursing, Youjiang Medical University for Nationalities, Guangxi Zhuang Autonomous Region, Baise 533000, China
[Abstract] Objective To construct a post-operative fecal risk assessment questionnaire (hereinafter referred to as “assessment questionnaire”) for children with hirschsprung’s disease (HSCR), and to provide a reference for early identification and intervention of high-risk groups of fecal soiling after HSCR. Methods Based on failure mode and effect analysis, from October 2020 to March 2021, a draft evaluation questionnaire was constructed through literature reading and group discussion, and then the first draft of the evaluation questionnaire was formed through an expert group discussion meeting. Finally, the Delphi method was used to conduct two rounds of correspondence to 16 experts in pediatric surgery-related fields, and the final draft of the evaluation questionnaire was initially established. Results In the two rounds of expert consultation, the recovery rate of the questionnaire was 100%, the authority coefficient was 0.925, 0.928, and the Kendall harmony coefficient was 0.318, 0.352 (P < 0.001). The final evaluation questionnaire includes four dimensions (primary indicators) and 15 items (secondary indicators). Conclusion The evaluation questionnaire constructed based on the Delphi method has good scientificity, reliability and comprehensiveness. To a certain extent, it can be used as an evaluation tool for the high-risk population of fecal soiling after HSCR, and has important guiding significance for the management of such populations.
[1] Tang W,Su Y,Yuan C,et al. Prospective study reveals a microbiome signature that predicts the occurrence of post-operative enterocolitis in Hirschsprung disease (HSCR) patients [J]. Gut Microbes,2020,11(4):842-854.
[2] Saadai P,Trappey AF,Goldstein AM,et al. Guidelines for the management of postoperative soiling in children with Hirschsprung disease [J]. Pediatr Surg Int,2019,35(8):829-834.
[3] 冯杰雄.先天性巨结肠及其同源病[M].北京:人民卫生出版社,2019.
[4] 李亮星.腹腔镜辅助经肛Soave手术与Swenson手术治疗常见型先天性巨结肠症的对比研究[D].石家庄:河北医科大学,2020.
[5] 朱天琦.先天性巨结肠的诊断及治疗专家共识[J].中华小儿外科杂志,2017,38(11):805-815.
[6] Huang WK,Li XL,Zhang J,et al. Prevalence,Risk Factors,and Prognosis of Postoperative Complications after Surgery for Hirschsprung Disease [J]. J Gastrointest Surg,2018,22(2):335-343.
[7] Espeso L,Coutable A,Flaum V,et al. Persistent Soiling Affects Quality of Life in Children with Hirschsprung’s Disease [J]. J Pediatr Gastroenterol Nutr,2020,70(2):238-242.
[8] Loganathan AK,Mathew AS,Kurian JJ. Assessment of Quality of Life and Functional Outcomes of Operated Cases of Hirschsprung Disease in a Developing Country [J]. Pediatr Gastroenterol Hepatol Nutr,2021,24(2):145-153.
[9] 孙瑛,尹强,唐倩,等.电刺激生物反馈干预结合康复护理在先天性巨结肠术后肛门失禁患儿中的应用[J].中国医药导报,2021,18(21):173-176.
[10] Jebb AT,Ng V,Tay L. A Review of Key Likert Scale Development Advances:1995-2019 [J]. Front Psychol,2021,12:637547.
[11] 高燕,叶萌,沈小平,等.基于德尔菲法构建老年女性压力性尿失禁患者的健康教育方案[J].中国医药导报,2021, 18(14):164-168.
[12] 黄师菊,钟美浓,蔡有弟,等.临床营养专科护士核心能力评价指标的构建[J].中华护理杂志,2020,55(11):1665-1672.
[13] 罗薇,高静,许冬梅,等.基于德尔菲法构建精神科护士医学保护性约束使用现状调查问卷[J].护理研究,2021, 35(1):22-27.
[14] 李平东,宫玉翠,陈洁雅,等.肺康复专科护理核心能力指标的构建[J].中华护理杂志,2020,55(8):1133-1139.
[15] 林音,祝雪花,陈英.社区护士应对突发公共卫生事件救援能力评价指标的构建[J].中华护理杂志,2021,56(8):1158-1164.
[16] 于奕,李暘,李姗姗,等.急性呼吸窘迫综合征患者俯卧位通气护理质量评价指标的构建[J].中华护理杂志,2021, 56(7):977-982.
[17] 杨小辉,赵媛媛,钮美娥.基于德尔菲法构建成人ICU患者压力性损伤风险评估工具[J].护士进修杂志,2019, 34(13):1157-1161.
[18] 刘树佳,江华,李魁星,等.血液专科护理质量指标的构建[J].中华护理杂志,2020,55(4):574-578.
[19] Zhang QP,Wang XT,Lu JQ,et al. Application of failure mode and effect analysis in reducing the risk of nosocomial infection [J]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi,2021,39(3):189-192.
[20] Feemster AA,Augustino M,Duncan R,et al. Use of failure modes and effects analysis to mitigate potential risks prior to implementation of an i ntravenous compounding technology [J]. Am J Health Syst Pharm,2021,78(14):1323-1329.
[21] 杨婧,沈丽琼,金晓燕.层次分析法在护理管理领域中的应用进展[J].中华现代护理杂志,2016,22(26):3837-3840.
[22] 陈珺仪,席淑新,石美琴.德尔菲法在专科护理质量评价指标研究中的应用现状[J].护理研究,2016,30(29):3591-3595.
[23] 龚小凤,孙晓嘉.护士核心能力评价指标体系框架的研究进展[J].解放军护理杂志,2016,33(21):46-48.
[24] Uylas U,Gunes O,Kayaalp C. Hirschsprung’s Disease Complicated by Sigmoid Volvulus:A Systematic Review [J]. Balkan Med J,2021,38(1):1-6.
[25] 任平,张玉侠,陈劼,等.肛门直肠畸形术后真性大便失禁患儿生活质量影响因素研究[J].护理学杂志,2018, 33(6):27-31.
[26] De la Torre L,Cogley K,Santos K,et al. The anal canal is the fine line between “fecal incontinence and colitis” after a pull-through for Hir schsprung disease [J]. J Pediatr Surg,2017,52(12):2011-2017.
[27] Dai Y,Deng Y,Lin Y,et al. Long-term outcomes and quality of life of patients with Hirschsprung disease:a systematic review and meta-analysis [J]. BMC Gastroenterol,2020,20(1):67.
[28] 黄文凯,李雪丽,张瑾,等.先天性巨结肠手术后近期并发症的发生率及危险因素分析[J].临床小儿外科杂志,2018,17(2):99-105.