Establishing A System Of Nursing With Syndrome Differentiation For Lumbar Disc Herniation On An Evidence-based Practice

Objective:To construct a system of nursing with syndrome differentiation for lumbar disc herniation that includes 'Bian Zheng' and 'Shi Hu'.Hence,providing some reference for the TCM nursing practice.This also lays a foundation for the integration of electronic nursing records and developing decision support.Methods:The present thesis,uses the means of literature analysis and the Delphi method.established the system of nursing with syndrome differentiation for lumbar disc herniation,which included 'Bian Zheng' and 'Shi Hu'.? Firstly,the study drafted the primary and secondary symptoms of lumbar disc herniation's common syndromes.A systematic criterion was set for literature inclusion and exclusion,and only 95 papers were included.Based on the statistical and logistic regression analysis,primary and secondary symptoms of lumbar disc herniation's common syndromes were established.Based on the results above and the relevant statements on the Industry Standard and Traditional Chinese Medicine Nursing Program of Dominant Diseases,the study prepared an expert consultation questionnaire for syndrome differentiation for lumbar disc herniation and selected 40 specialists from different areas.After two rounds of consultation,the primary and secondary symptoms of lumbar disc herniation's common syndromes using the Delphi method were established.? Based on a rigorous retrieval strategy,using The Joanna Briggs Institute method of evidence and quality evaluation to analysis literature,the evidence of nursing with syndrome differentiation were summed up.Using the Delphi method and the 5 Likert scale method,their feasibility and rationality were evaluated.By two rounds,the program of nursing with syndrome differentiation of lumbar disc herniation was established.The reliability and representation of the expert consultation were evaluated by using the positive coefficient,the authority coefficient,the coefficient of variation and the coordination coefficient of the experts.Results:? By summarizing the different analysis methods and the results,according to the drafted judge method and the common syndrome's primary and secondary symptoms,there are four types of common syndromes called Xue yu qi zhi,Han shi bi zu,Shi re bi zu and Gan shen kui xu.? Through evidence-based literature analysis and the Delphi expert consultation,a syndrome differentiation nursing program for lumbar disc herniation was constructed.It contained providing appropriate technology for TCM nursing to different syndromes,carrying out different health education and implementing different diet care.In the program,there were 19 entries of 9 categories appropriate technologies of TCM nursing,13 entries of 5 categories of health education and 7 entries of 4 categories of diet care for the Xue yu qi zhi type.There were 18 entries of 9 categories of TCM appropriate technologies,13 entries of 5 categories of health education and 5 entries of 3 categories of diet care or Han shi bi zu type.There were 12 entries of 7 categories of TCM appropriate technologies,12 entries of 4 categories of health education and 6 entries of 4 categories of diet care for the Shi re bi zu type.There were 14 entries of 6 categories of TCM appropriate technologies,12 entries of 5 categories of health education and 4 entries of 7 categories of diet care Gan for the shen kui xu type.? During the consultation of the lumbar disc herniation's syndrome differentiation,two rounds of the Delphi method's reliability analysis showed the following coefficients:the expert positive coefficient were 80%and 90.63%,the authority coefficients were 0.89 vs 0.86,the entries coefficient of variation were 0.08-0.41 and 0.10-0.39,the entry levels of Kendall's coefficient of concordance(W)were 0.19-0.39 and 0.45-0.61,and all P values were less than 0.01 by chi-square test.After two rounds of consulting,the Delphi method for the program of nursing with syndrome differentiation revealed that the expert positive coefficient were 87.5%VS 90.63%,the authority coefficients were both 0.87,the entries coefficient of variation were 0.08-0.37 and 0.09-0.32,the entry levels of Kendall's coefficient of concordance(W)were 0.12-0.17 and 0.13-0.33,and all of them were with statistical significance by chi-square test of(P<0.01)Conclusions:In this thesis,different methods were used to build a method of nursing with syndrome differentiation system for lumbar disc herniation,including 'Bian Zheng' and 'Shi Hu':By defining primary and secondary symptoms of common syndromes of lumbar disc herniation.The syndrome differentiation was more completed and the difficulty of syndrome differentiation would be reduced.The program involved giving the appropriate technology for TCM nursing to each different syndrome,carrying out different health educations and implementing different diet cares.Yet the system still needs to be further examined and verified.