围绝经期症状管理非药物治疗决策辅助工具的构建与评价研究

doi:10.3761/j.issn.1672-9234.2025.10.018

摘要/Abstract

摘要：

目的构建围绝经期症状管理非药物决策辅助工具，为围绝经期症状管理及医患共同决策提供参考。方法以渥太华决策支持框架为理论依据，以中国患者决策辅助工具开发流程与方法为指导，经文献回顾、网状Meta分析及证据总结形成供医护人员使用的决策辅助工作表和面向围绝经期女性的决策辅助手册。通过2轮德尔菲法对决策辅助工作表进行评价、修订；经专家会议确定手册内容及形式；经外部评审评价工具的可用性与可接受性。选取20名女性进行试点应用，采用访谈法评估工具的可读性和可行性，修订形成终版工具。结果 2轮专家函询的专家积极系数分别为85%和100%，权威系数均为0.888，专家协调系数分别为0.296和0.384（P<0.05）。专家会议的权威系数为0.865。外部评审表明，工具质量较高，符合应用条件。试点应用中，95%的女性认为工具信息易懂，具备良好的可读性和可行性。形成决策辅助工作表（4个一级项目、13个二级项目、59个三级项目）和64页决策辅助手册（包括更年期症状管理非药物决策一览表、更年期知识、症状评估、生活方式调整、非药物疗法、附录）。结论该工具具有科学性和适用性，将最佳证据和女性价值偏好相结合，可为围绝经期症状管理决策提供参考。

关键词: 围绝经期, 症状管理, 非药物, 决策辅助工具, 护理

Abstract:

Objective To develop a non-pharmacological decision aid for perimenopausal symptom management，to provide reference for perimenopausal symptom management and shared decision-making between doctors and patients. Methods Based on the Ottawa Decision Support Framework and guided by the development process for patient decision aids in China，a draft decision worksheet and handbook were developed through literature review，network meta-analysis，and evidence synthesis. The worksheet was revised through two rounds of Delphi consultation，and the content and format of the handbook were finalized via expert meetings. External review was conducted to assess the tool's usability and acceptability. A pilot study with 20 women was carried out to evaluate the tool's readability and feasibility through interviews，leading to the finalized version. Results The positive coefficients of the experts in the two rounds of expert inquiries were 85% and 100% respectively，and the authority coefficients were both 0.888. The coordination coefficients were 0.296 and 0.384（P<0.05）. The authority coefficient of the expert meeting was 0.865. The external review indicated that the tool was of high quality and met the application conditions. In the pilot study，95% of women found the information clear，showing good readability and feasibility. The final tool included a worksheet with four primary items，13 secondary items，and 59 tertiary items，plus a 64-page handbook including non-pharmacological decision guide for menopause symptom management，menopause knowledge，symptom assessment，lifestyle modifications，non-drug therapies，appendix. Conclusion The tool is scientific and applicable. By combining the best evidence and the value preferences of women，it can provide a reference for decision-making in the management of perimenopausal symptoms.

Key words: Perimenopause, Symptom management, Non-pharmacological, Decision support tool, Nursing

牛旭蕾, 郭晓琴, 郭雪桃, 王倩倩, 田昱敏. 围绝经期症状管理非药物治疗决策辅助工具的构建与评价研究[J]. 中华护理教育, 2025, 22(10): 1265-1272.

NIU Xulei, GUO Xiaoqin, GUO Xuetao, WANG Qianqian, TIAN Yumin. Development and evaluation of a decision aid for non-pharmacological treatment of perimenopausal symptom management[J]. Chinese Journal of Nursing Education, 2025, 22(10): 1265-1272.

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