Construction Of Nutrition Management Scheme For Patients With Chronic Kidney Disease

ObjectiveBased on the theory of evidence-based nursing and Delphi expert letter inquiry method,this study established a systematic and standardized nutrition management scheme for patients with chronic kidney disease,in order to provide reference for nutrition management practice.Methods1.Establish a research team,systematically search domestic and foreign literatures on nutrition management of patients with CKD in recent years,refine and summarize the contents through literature screening,literature quality evaluation and data extraction,and determine the key links of nutrition management of patients with CKD.To formulate a nutrition management scheme for patients with CKD.2.Based on the Delphi expert letter consultation method,the preliminary draft of the nutrition management scheme for patients with CKD was consulted by expert letter,and the contents of the scheme were deleted,modified and improved according to the expert opinions,so as to form a systematic,comprehensive and standardized nutrition management scheme for patients with CKD.Results1.After literature search and literature quality evaluation,32 literatures were finally included in this study,including 9 guidelines and consensus,9 systematic reviews and metaanalyses,13 randomized controlled trials,and 1 industry standard.Based on the summary of evidence,a preliminary draft of the nutrition management scheme for patients with CKD including 6 first-level items,27 second-level items and 52 third-level items was formulated.2.The recovery rates of the two rounds of expert letter consultation were 100% and95.2%,respectively.The authority coefficient of the first round of expert letter consultation was 0.86,the Kendall harmony coefficient of item importance and operability were 0.185～0.306 and 0.186～0.285,and the coefficient of variation of item importance and operability were 0.06～0.39 and 0.11～0.51,with P values less than 0.001.The authority coefficient of the second round of expert letter consultation was 0.89,the Kendall harmony coefficient of item importance and operability were 0.345～0.206 and 0.298～0.190,the coefficient of variation of item importance and operability were 0.00～0.20 and 0.06～0.22,and the P values were all less than 0.001.Through expert letter consultation and group discussion,the final draft of 6 first-level items,23 second-level items and 52 third-level items was finalized.ConclusionThe nutrition management scheme for patients with CKD constructed in this study included six aspects: nutrition management personnel,nutrition risk screening,nutrition assessment,nutrition treatment,nutrition monitoring and nutrition health education.The construction process was rigorous,and the results were scientific and reliable.This scheme clarified the related contents and provided evidence support for nutrition management of patients with CKD,and provided a theoretical basis for further application and promotion.