以两种谵妄预测模型为导向的ICU患者谵妄分级管理方案研究

doi:10.3761/j.issn.2096-7446.2025.02.001

摘要/Abstract

摘要：

目的构建以两种谵妄预测模型为导向的ICU患者谵妄分级管理方案，并初步评价其应用效果。方法通过文献查阅和德尔菲专家函询，构建以两种谵妄预测模型为导向的ICU患者谵妄分级管理方案，采用便利抽样法，将2023年12月—2024年2月入院的169例患者作为试验组，按照所构建的管理方案进行干预，将2023年9月—11月入院的147例患者作为对照组，接受常规护理，比较两组谵妄发生率。结果共16名专家完成2轮函询，有效问卷回收分别分为100%、93.75%，专家权威系数均为0.89。2轮专家函询后条目重要性及可操作性的肯德尔和谐系数分别为0.151、0.193（P<0.01）。最终构建的方案包括10个一级条目，31个二级条目，34个三级条目。应用结果显示，试验组谵妄发生率（12.42%）低于对照组（21.09%），差异具有统计学意义（P=0.038）。结论以两种谵妄预测模型为导向的ICU患者谵妄分级管理方案为多学科合作规范管理ICU患者谵妄提供理论依据和实践指导，可降低ICU患者谵妄发生率。

关键词: 重症监护, 谵妄, 管理, 护理, 方案构建

Abstract:

Objective To construct a delirium grading management plan for critically ill patients guided by combined delirium prediction models，and to preliminarily explore its application effects. Methods Through literature review and Delphi expert consultation，a delirium grading management plan for critically ill patients guided by combined delirium prediction models was constructed. Using convenience sampling method，169 patients admitted from December 2023 to February 2024 were recruited as the experimental group，which was intervened according to the constructed management plan，and 147 patients admitted from September to November 2023 were included as the control group and received routine care. The incidence of delirium was compared between the two groups. Results A total of 16 experts completed two rounds of consultation. The response rates of effective questionnaires were 100% and 93.75%，respectively，and the expert authority coefficients were both 0.89. After 2 rounds of expert consultation，the Kendall coefficients of the importance and operability of the items were 0.151 and 0.193，respectively（P<0.01）. The final plan included 10 primary items，31 secondary items，and 34 tertiary items. The application results showed that the incidence of delirium in the experimental group（12.42%） was lower than that in the control group（21.09%），and the difference was statistically significant（P=0.038）. Conclusion The delirium grading management plan for critically ill patients，guided by the combined delirium prediction models，provides theoretical basis and practical guidance for multidisciplinary cooperation in standardized management of delirium in ICU，and can reduce the incidence of delirium in critically ill patients.

Key words: Intensive Care, Delirium, Management, Nursing Care, Plan Construction

叶向红, 袁梦湄, 陈新美, 潘利飞, 庄敏玲. 以两种谵妄预测模型为导向的ICU患者谵妄分级管理方案研究[J]. 中华急危重症护理杂志, 2025, 6(2): 133-138.

YE Xianghong, YUAN Mengmei, CHEN Xinmei, PAN Lifei, ZHUANG Minling. Construction and effect evaluation of ICU delirium grading management plan based on combined delirium prediction models[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(2): 133-138.

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