[基于德尔菲法建立烧伤患者面部和颈部伤口及疤痕地形图评估系统]。

R H Bian, S X Huang, J Y Zhu, J Wu, K W Fan, Z C Hu, Y B Xu, Q H Yu, T Zhang, X Y Li, S Z Chen
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引用次数: 0

摘要

目的为烧伤患者的面部和颈部伤口及疤痕构建一个有针对性的准确评估系统。方法:采用文献分析与调查研究相结合的方法,遵循项目体系构建的基本原则:采用文献分析与调查研究相结合的方法,遵循项目体系构建的基本原则。2020年6月至8月,依据面颈部整形美学标准,初步形成烧伤患者面颈部创面及疤痕地形图评估体系,重点评估烧伤后患者颈部和面部的创面及疤痕。2020 年 9 月,提前征求了 38 位相关领域专家的意见,并根据专家意见对问卷进行了修改。2020年12月至2021年3月,采用德尔菲法对来自广州、深圳、上海、北京等地符合纳入标准的35名相关领域专家进行函询,筛选并确定了调查项目。通过计算调查问卷的有效回收率来确定专家的积极程度,通过计算所有项目的平均权威系数来确定专家的权威程度,通过计算所有三级项目的重要性专家平均得分、平均变异系数和平均满分率来确定专家意见的集中程度,通过计算所有三级项目的重要性、敏感性和可操作性专家得分的平均变异系数和肯德尔和谐系数来确定专家意见的协调程度。所有三级项目的重要性、敏感性和可操作性专家评分的肯德尔和谐系数采用卡方检验进行统计分析。结果:德尔菲法咨询的 35 位专家中,以男性为主,年龄(48±10)岁,工作年限 8-38 年,以副高级及以上职称为主,学历均为本科及以上,其中烧伤专家 11 人,创面修复专家 7 人,整形外科专家 4 人,康复医学专家 13 人。最终形成了烧伤患者面部、颈部创面及疤痕地形图评估体系,包括4个一级项目、21个二级项目、40个三级项目和1个掩膜。调查问卷的有效回收率为 100%(35/35)。所有项目的平均权威系数为 0.89。重要性专家平均得分 4.67,重要性专家得分的平均变异系数为 0.01,所有三级项目的平均满分率为 86.3%。所有三级项目的重要性、敏感性和可操作性专家评分的平均变异系数分别为 0.01、0.01 和 0.02。所有三级项目的重要性、敏感性和可操作性专家评分的 Kendall 和谐系数均有统计学意义(χ2 值分别为 1 201.53、745.67 和 707.07,PConclusions:建立的烧伤患者面颈部创面及疤痕地形图评估系统具有较高的科学性和可靠性,可用于烧伤患者面颈部创面或疤痕的评估。
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[Establishment of a topographic map assessment system for facial and cervical wounds and scars of burn patients based on the Delphi method].

Objective: To construct a targeted and accurate evaluation system for facial and cervical wounds and scars of burn patients. Methods: The method combining literature analysis and survey research was adopted, and the basic principles of item system construction were followed. From June to August 2020, based on the aesthetic standards of facial and cervical plastic surgery, the topographic map assessment system for facial and cervical wounds and scars of burn patients was preliminarily formed, focusing on the assessment of wounds and scars in the necks and faces of patients after burns. In September 2020, 38 experts in the relevant fields were consulted in advance and the questionnaire was revised according to the experts' opinions. From December 2020 to March 2021, the Delphi method was applied to conduct inquiry by correspondence with 35 experts in relevant fields from Guangzhou, Shenzhen, Shanghai, Beijing, and other cities, who met the inclusion criteria, and the items were screened and established. The effective recovery rate of inquiry questionnaire was calculated to determine the level of enthusiasm of experts, the average authority coefficient of all items was calculated to determine the level of expert authority, the average importance expert score, the average coefficient of variation, and the average full score rate of all the third-level items were calculated to determine the concentration of expert opinions, the average coefficients of variation and Kendall's harmony coefficients of the importance, sensitivity, and operability expert scores of all the third-level items were calculated to determine the degree of coordination of expert opinions. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically analyzed with chi-square test. Results: Among the 35 experts consulted by Delphi method, mainly were male, aged (48±10) years, with 8-38 years of working experience, mainly with associate senior titles and above, all with a bachelor's degree or above education background, and of whom 11 were burn experts, 7 were wound repair experts, 4 were plastic surgery experts, and 13 were rehabilitation medicine experts. Finally, a topographic map assessment system for facial and cervical wounds and scars of burn patients was formed, including 4 first-level items, 21 second-level items, 40 third-level items, and 1 mask. The effective recovery rate of inquiry questionnaire was 100% (35/35). The average authority coefficient of all items was 0.89. The average importance expert score was 4.67, the average coefficient of variation of importance expert score was 0.01, and the average full score rate of all the third-level items was 86.3%. The average coefficients of variation of the importance, sensitivity, and operability expert scores of all the third-level items were 0.01, 0.01, and 0.02, respectively. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically significant (with χ2 values of 1 201.53, 745.67, and 707.07, respectively, P<0.05). Conclusions: The established topographic map assessment system for facial and cervical wounds and scars of burn patients has high scientificity and reliability, which can be used for the evaluation of facial and neck wounds or scars in burn patients.

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来源期刊
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期刊介绍: The Chinese Journal of Burns is the most authoritative one in academic circles of burn medicine in China. It adheres to the principle of combining theory with practice and integrating popularization with progress and reflects advancements in clinical and scientific research in the field of burn in China. The readers of the journal include burn and plastic clinicians, and researchers focusing on burn area. The burn refers to many correlative medicine including pathophysiology, pathology, immunology, microbiology, biochemistry, cell biology, molecular biology, and bioengineering, etc. Shock, infection, internal organ injury, electrolytes and acid-base, wound repair and reconstruction, rehabilitation, all of which are also the basic problems of surgery.
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