Construction And Application Of Self-reporting Scale For Patients With Miles Postoperative Discomfort

Objective:1.Establishing a self-report scale for patients with Miles postoperative discomfort,to accurately evaluate the physical and psychological discomfort of patients after Miles postoperation;2.Using the self-reported scale for patients’ discomfort after the Miles surgery was constructed,the patients and nurses were surveyed simultaneously to verify the consistency of the results and provide a reference for clinical decision-making.Methods:1.Method for constructing self-reported scale for patients’ discomfort after Miles surgery(1)Qualitative research: The dimensions and entry pools of the self-reporting scale for patient discomfort after Miles surgery were formed by reading the literature and guidelines,and the discussion of the research team.Nine Miles patients who underwent semi-structured in-depth interviews were selected from 4 tertiary first-class hospitals in Nanchang.To further refine the dimensions and content of the entry pool.(2)Delphi Expert Correspondence: using purpose sampling to select 21 clinical nursing experts,nursing management experts,and nursing education experts who have been engaged in the field of gastrointestinal tumors for a long time.Through 2rounds of expert correspondence,the questionnaire entries and content were analyzed.Scientifically adjusted to form an initial self-reported scale for patient discomfort after Miles surgery.(3)Pre-survey: Using the initial scale and employing convenient sampling method to extract 101 from nanchang line 4 level of first-class hospital Miles within 3months after preliminary investigation of colorectal cancer patients,using statistical methods of item analysis,exploratory factor analysis analysis of survey data,the entry and screening test,reliability and validity of form the formal scale.2.Consistency test between self-report of patient discomfort and nurse report after Miles surgery.A convenient sampling method was used to select patients who were admitted to a tertiary Class A hospital in Nanchang City after undergoing Miles surgery.The self-designed general condition questionnaire and self-reported scale for the patient’sdiscomfort after Miles surgery were used to measure 138 patients The hospitalized patients were investigated,and the responsible nurse filled out a discomfort during the postoperative hospitalization of the patient based on his previous medical records to verify the consistency between the patients’ report and the nurses’ report.3.Statistical method: Use Excel to enter the questionnaire data,and employ SPSS22.0 software to perform statistical analysis on the entered data.counting data is described by frequency,composition ratio,and median,and measurement data is described by mean ± standard deviation;scale Construction using the coefficient of variation method,correlation coefficient method,reliability and validity test,exploratory factor analysis;comparison of nursing records using Mc Nemar test,Wilcoxon rank sum test and Kappa consistency test.Results:1.Results of self-reporting scale for patients with Miles postoperative discomfort(1)Qualitative research results: The qualitative research formed 2 dimensions,32 entries,which were 17 entries in the physiological dimension and 15 entries in the psychological dimension.(2)Delphi expert inquiry result: After two rounds of expert inquiry,an initial scale consisting of 2 dimensions and 25 items was formed.The positive coefficients of the experts in the second round of consultation were 100%,the proportion of experts who gave opinions in the second round of consultation were 100% and14.29%,the authoritative coefficients of the experts in the second round of consultation were 0.812,and the overall coefficient of variation in the second round of consultation was 0.15.~ 0.19,the coordination coefficient is 0.115 ~ 0.198,and the difference is statistically significant after the chi-square test(P <0.05);two rounds of correspondence have revised a total of 8 entries,merged 2 entries,and deleted 6entries.(3)Reliability and validity evaluation results of the scale: The items were not deleted after the analysis of the items.The data results show that the Cronbach’s αcoefficients of the total scale and physiological and psychological dimensions are0.853,0.765,and 0.805;the split-half reliability is 0.725,0.745,0.783,scale-level content validity(S-CVI)is 0.98,and item-level content validity(I-CVI)is 0.80 to1.00.The final scale contains 25 items in 2 dimensions,of which 13 items are in the physiological dimension,and psychological 12 entries of dimensions.2.Self-report and patient-reported results of patient discomfort after Miles surgeryThe average age of the survey participants was(64.54 ± 9.25)years old.The total score of patients who reported postoperative discomfort was(87.67 ± 13.33)points,the physical dimension score was(44.44 ± 8.90)points,and the psychological dimension score was(43.22 ± 8.61)points.The nurse reported that the patient’s total discomfort score was(63.78 ± 8.76)points,the physical dimension score was(33.35± 7.15)points,and the psychological dimension score was(30.43 ± 6.67)points.Patients reported that the incidence and severity of postoperative discomfort in Miles were generally higher than those reported by nurses.Conclusions:According to the scale construction process,this study constructed the Self-Report Scale of Patient Discomfort Response after Miles.It has been tested with good reliability,validity and feasibility,and can be used by clinical medical staff to evaluate patient discomfort response after Miles;Miles operation More than half of the incidence and severity of uncomfortable reactions reported by post-patients are higher than those reported by nurses,reflecting the underestimation of clinical post-operative discomfort for patients,suggesting that medical staff can use patient self-reports to pay attention to postoperative patients The discomfort reflects the symptoms,thereby making relevant clinical nursing decisions.