Based On The "Nursing Outcomes Classification", A Core Index Set Of Nursing Outcomes For Patients With Knee Paralysis Was Constructed

Objectives:1.Construct a core-nursing-outcome-indicator group for patients with knee osteoarthritis;2.Revise the core-nursing-outcome-indicator group for patients with knee osteoarthritis to form an effect evaluation paradigm which suits for our native language environment,targeted at patients with knee osteoarthritis,and completes the integration of Traditional Chinese Medicine and Western nursing terminologies for knee osteoarthritis,to benefit and further the research on nursing outcome classifications and clinical nursing work for patients with knee osteoarthritis in the later stage.Methods:1.Use the literature review method to search the core journals of knee osteoarthritis nursing in the China National Knowledge Infrastructure(CNKI),Wanfang Database and China Biomedical Literature Database(CBM);use the purpose sampling method and follow the principle of information saturation,from March 2020 to June 2020,a total of 20 people,including surgical doctors,nurses,and all patients diagnosed with knee osteoarthritis(KOA)were selected for semi-structured interviews from an A-grade hospital in Shenyang to obtain the main informations of symptoms,common nursing diagnosis of knee osteoarthritis and patient outcomes that doctors,nurses,patients most care about separately.2.Through experts discussions,the Traditional Chinese Medicine and western nursing terminologies of knee osteoarthritis were merged following the results of literature review method and semi-structured interviews;By facilitating sampling method,from June 2020 to September 2020,a questionnaire survey was conducted among nurses in A-grade hospitals in Shenyang,supported by the electronic platform "Questionnaire Star" for data collection,and the frequency of those nursing diagnosis which is more than 50% were regarded as common nursing diagnosis of knee osteoarthritis.3.Based on "Nursing Outcome Classifications",combined with the results of literature review,semi-structured interview,expert discussions and questionnaire survey,the core nursing outcome indicators for knee osteoarthritis were initially selected,and were compiled into questionnaires.Using the purpose sampling method,from September to December 2020,20 experts were selected from A-grade hospitals in Shenyang to conduct two rounds of Delphi experts consultations,and calculating the average value,coefficient of variation and weight of the importance of each index,and using the positive coefficient,authoritative coefficient,and coordination coefficient of experts,to analyze experts' reliability and representativeness,and to construct a final draft of the core-nursing-outcome-indicator group for patients with knee osteoarthritis.Results:1.Respectively retrieved 28 and 394 and 576 literatures from CNKI,Wanfang database and CBM.According to the inclusion criteria,235 documents were eliminated,among which95 literatures did not meet the inclusion criteria,and 223 were repeated.Finally,258 articles were included for analysis.Use Excel23 to perform statistical analysis to record the Traditional Chinese Medicine and western diagnosis and symptoms of knee osteoarthritis,including "Pain","Sore Tenderness","Heavy","Numbness","Swelling","Tenderness","Snapping","Stiffness","Dysfunction","Bruit de Frottement","Deformity","Osteophyte","Unfavorable joint flexion and extension"," Tumefaction","Deformation","Pain","Joint stiffness","Limited joint movement","Physical mobility disorder","Sleep disorders","risk of ineffective individual response","deficiency in self-care ability","risk of interruption of family operations","risk of improper or ineffective treatment plans" Interviewing 8 surgical doctors,12 surgical nurses,and 10 patients with knee osteoarthritis.The transcribed text data is about 50,000 words,which abstracts opinions that are relatively concentrated on knee osteoarthritis symptoms,nursing diagnosis,compliance,satisfaction,self-management ability of patients et al.2.Through the experts' discussions,the TCM symptoms "Sore Tenderness" and "Heavy" were classified as the western nursing diagnosis of "pain" and "fatigue";the TCM symptom "numbness" is classified as the western nursing diagnosis of "Physical mobility disorder".Through the questionnaire survey of clinical nurses,4 nursing diagnoses with a frequency of use greater than 50% were screened out,and in descending order of frequency of use,which was "disorders of physical movement","disorder of sleep patterns",and "pain","Defects in self-care ability",and initially formed the first draft of the core-nursing-outcome-indicator group consisting of 6 domains(first-level indicators),37 nursing outcomes(second-level indicators)and 224 nursing outcome indicators(third-level indicators).3.Through two rounds of Delphi experts consultations,a final draft of the core-nursing-outcome-indicator group including 5 first-level indicators,28 second-level indicators,and 90 third-level indicators was finally formed.Among them,the average importance scores of the first-level indicators are as follows: 4.7,4.4,4.25,3.55,3.5,the average range of the second-level index importance score is 3.5-4.7,and the average range of the third-level index importance score is 3.5-4.7.20 experts were consulted at this stage,and the age of the experts is 36-58 years old,working years is 10 to 38.The positive coefficients of the two rounds of expert consultation were respectively 100% and 100%,and the authoritative coefficients were 0.7125 and 0.8325.After the two rounds of consultations,the coordination coefficients of indicators at all levels were 0.322 and 0.538,and the test results were statistically significant(P<0.01),indicating that consulting experts have good reliability and representativeness.Conclusions:This study constructed a core-nursing-outcome-indicator group for patients with knee osteoarthritis through literature review,semi-structured interviews,experts discussions,questionnaire survey and Delphi method.This indicator group can provide theoretical basis and reference for carrying out clinical nursing work and nursing effect evaluation of knee osteoarthritis and other specialist diseases.