基于慢性病轨迹模式的活动期类风湿关节炎衰弱病人护理管理方案的构建

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based on thechronic illness trajectorymodel

XU Renju，ZHU Yuxuan，ZHU Manli，CHEN Yujie，SUN Yue，CHEN Yan*

Drum Tower Hospital Affiliated to Medical School of Nanjing University，Jiangsu 210o08 China

*Corresponding Author CHEN Yan，E-mail： njchenyan@126.com

AbstractObjective：Toconstructanursingmanagementprotocolforfrailprotocolwithactiveheumatoidarthritis（RA）basedonth chronicilsdoelilih reviewfindingswereintegratedTeinitialdaftofteursingmanagementprotocolforfrailpatientsithactiveRAasgraduayefie andimprovedthroughpaeldiscuion.TworoundsofDlphiexpertcosultatioswereconductedtofurtherreviseandfialieteprotool

Results：The effective response rates for both rounds of expert consultations were 100.00% .The expert authority coefficient was O.94.In thesecondroudofconsultations，teitemsimportancesoresfortheacutepaseadsubacutephaserangedfrom4.48to.ad4.43to 5.00，respectively.The Kendal's harmony coeficientswere O.236 and O.217，respectively（all P<0.001 ）.Thevariationcoefficientsranged fromO.0OtoOadOOOtoO2espectivelyInthesecodoundfonsultatios，teitemsfeasibilitysoesfortheacuteasead subacutepaseagedfro435tond0Oto496espctivelyeKendalsaoyoefcentsereO92astiely （all P<0.001 0.ThevariationcoeficientsrangedfromO.OOtoO.13andO.04to0.2O，respectively.Thefinalprotocolincluded3first-level items，7secodeliddelifoutesndisels，cdveid9del itemsforthesubacutephaseConclusions：ThethenursingmanagementprotocolforfrailpatientswithactiveRAconstructedinthisstudy wasscientific，reliable，comprehensive，clinicallyapplicable，and feasible.

Keywordschronicillness trajectorymodel; rheumatoidarthritis;frailty;activephase;Delphimethod;protocolconstruction

类风湿关节炎（rheumatoidarthritis，RA）是一种以慢性多关节炎为主要表现的自身免疫疾病，其发病率高、致残率高[1-2]，我国 90% 的RA病人处于中重度活动期且预后不良[3]。（剩余12463字）