| ObjectiveGuided by the theory of goal-oriented theory,this study constructs a nursing program for chronic constipation with fecal microbiota transplantation through field research,qualitative research and Delphi expert consultation,and verifies the scientificity and effectiveness of the constructed nursing program through quasiexperimental research.The goal is to further standardize the practice behavior of nursing staff in the whole process of fecal microbiota transplantation treatment for chronic constipation,optimize the work details,and meet the individualized needs of patients and donors,so as to ensure the quality of fecal microbiota transplantation nursing service,and to help patients with chronic constipation recover quickly,improve their recovery and improve their quality of life.Methods1.Select the intestinal micro-ecology diagnosis and treatment center of a tertiary A first-class hospital in shanghai as the field,understand the specific work flow and details of nursing care in the treatment of chronic constipation patients with fecal microbiota transplantation through field survey,and pay attention to analyze the key points and difficulties in the current nursing work.Based on the goal-oriented theory,determine the central goal of the proposed program,and initially develop the framework of the fecal microbiota transplantation nursing program for patients with chronic constipation.2.Using qualitative research method,through semi-structured interviews with donors,medical staff and patients with chronic constipation in the intestinal microecological diagnosis and treatment center of a tertiary A first-class hospital in shanghai,to investigate the current problems in the nursing work of patients with chronic constipation with fecal microbiota transplantation treatment,normative suggestions and the needs of the service objects involved,so as to decompose the central goal expected to be achieved in the proposed construction plan into multi-dimensional small goals,Get specific ways to achieve goals.After integrating the interview results and determining the grading indicators of the scheme,the first draft of the scheme is formed.3.Using Delphi expert inquiry method,according to the principle of "scientificity,reliability,authority and representativeness",select experts with a certain degree of authority and academic level in the field of fecal microbiota transplantation treatment to conduct Delphi expert consultation on the preliminary draft of the nursing program for chronic constipation with fecal microbiota transplantation,and finally form the nursing program to guide the standardized development of the nursing work for chronic constipation with fecal microbiota transplantation.4.Through the method of quasi-experimental research,the formed nursing program for chronic constipation with fecal microbiota transplantation was applied to the clinic,and the effect of the plan on the clinical symptoms,quality of life,and adverse reactions in the process of fecal microbiota transplantation treatment for patients with chronic constipation was discussed,in order to verify the scientificity and effectiveness of the constructed program.Results1.Through field research,understand the nursing process and practice status of fecal microbiota transplantation for patients with chronic constipation.The nursing content of fecal microbiota transplantation for patients with chronic constipation includes donor management,bacterial fluid management,and clinical nursing;Nurses have room for improvement in such aspects as admission health education,donor follow-up,maintenance of transplantation pathway,intestinal preparation,infusion of bacterial fluid,observation and treatment of complications,health education and follow-up.Based on the goal-oriented theory,3 target objects and 10 guiding processes of the program were determined,namely the framework of the nursing program.2.Through qualitative research,through semi-structured interviews with 20 medical and nursing staff,10 bacterial donors and 10 patients with chronic constipation,we learned the standardized suggestions for all aspects of the care of chronic constipation with fecal microbiota transplantation and the personalized needs of the service objects,and finally determined the first draft of the nursing program,including 3 first-level indicators,10 second-level indicators,and 50 third-level indicators.3.Through Delphi expert inquiry method,a total of 15 experts engaged in bacterial colony transplantation treatment or nursing work were selected to revise the preliminary draft of the program formed in the early stage to conduct the index inquiry.The authority coefficient(Cr)of the experts was 0.933 and 0.937,the effective recovery rate of the two rounds of expert inquiry questionnaire was 100.00%,and the Kendall coordination coefficient was 0.643 and 0.238.The final nursing program for chronic constipation with fecal microbiota transplantation included 3 first-level indicators 11 secondary indicators and 46 tertiary indicators.4.Carry out a non-synchronous controlled trial,using the objective sampling method,select the patients who meet the inclusion criteria in a tertiary A first-class hospital in shanghai from May 2021 to August 2022 as the control group;The patients who met the inclusion criteria from September 2022 to December 2022 were set as the intervention group.33 patients were selected from each group.The control group carried out routine nursing work,and the experimental group carried out the formed flora transplantation nursing program.The results showed that the baseline data of the two groups were not statistically significant(p>0.05).After the implementation of the nursing program,the "Wexner constipation score","constipation patient symptom selfscore,"constipation patient quality of life score" and "inpatient satisfaction score" of the two groups were significantly different(p<0.05);"Bristol stool trait score" had significant difference only in the third month after discharge(p<0.05).Among the complications,only the incidence of throat pain was statistically significant(p<0.05).Conclusion1.This study adopts the field research method,qualitative research method,Delphi expert inquiry method,and under the guidance of the goal-oriented theory,constructs a nursing program for chronic constipation with fecal microbiota transplantation,which is optimized from the work content and process of donor management,bacterial fluid management,and clinical nursing.The content of the plan is composed of 5 first-level indicators,15 second-level indicators,and 63 third-level indicators.2.Through non-synchronous controlled trials,the application of the program in clinical practice can consolidate the therapeutic effect of fecal microbiota transplantation,effectively relieve the symptoms of constipation patients,improve the quality of life,improve the satisfaction of patients in hospital,and reduce the incidence of throat pain,thus verifying the scientific and clinical applicability of the program,and providing theoretical basis for the development of chronic constipation with fecal microbiota transplantation nursing work,so as to improve the quality of nursing care for chronic constipation with fecal microbiota transplantation and promote the rehabilitation of patients. |
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