| ObjectiveThe study is to establish a risk assessment scale("scale")for patients without heparin hemodialysis by means of literature search,expert Consultation,group discussion and analytic hierarchy process.As a tool for blood coagulation risk assessment in patients without heparin hemodialysis,it provides a clinical reference for risk prevention and control in patients without heparin hemodialysis.MethodsThrough literature search and analysis of the high risk factors of blood coagulation during cardiopulmonary bypass without heparin,the framework of the blood coagulation risk assessment scale was preliminarily constructed.Using the Delphi Expert Function Inquiry Method(Delphi method)and analytic Hierarchy Process(AHP),18 experts were invited to consult in the field of hemodialysis,and after two rounds of expert inquiry Group,the first draft of blood coagulation risk assessment in cardiopulmonary bypass was determined.30 patients with no heparin hemodialysis at the dialysis center of the first Hospital of Jilin University were selected from June 2017 to December 2017.Revise the first draft of the scale,form the formal scale and test the reliability and validity.Results1.The representative of this research expert and the reliability of consultation: the recovery rate of the two rounds of expert inquiry questionnaire is 100%,which indicates that the experts have high enthusiasm for this research;through the qualitative analysis of the experts ' basic situation and the quantitative analysis of the experts ' authority,it shows that the expert authority coefficient is0.848 ? 0.860,> 0.700,the Expert Group has good representativeness and authority;after two rounds of inquiry,the coordination coefficient of system index was 0.29 and 0.42,and the coordination in the Expert Group was high.2.After two rounds of consultation with 18 experts,the risk assessment scale of no heparin hemodialysis was constructed,which covered the first level index 4 and two grade 18.3,Using analytic Hierarchy Process Analysis index weight and consistency test,this study first level index CR value is 0.0801,the CR value of two grade index is 0.0000~0.0478,generally think consistency test CR value 0.1,conform to consistency test,show that the evaluation index system that this research constructs conforms to logic consistent sexual requirements.4.The reliability test of the risk assessment scale of heparin-free hemodialysis:(1)The overall consistency of the scale Cronbach ' s ?=0.822,4 dimension Cronbach ' S ? was 0.726,0.709,0.745,0.802,which indicated that the reliability of the questionnaire was better,has high internal consistency.(2)Content validity: 18 experts evaluated the content validity of the scale,and the overall content validity index(CVI)of the scale was 0.886,4 dimension CVI 0.896,0.917,0.875,0.833 respectively.The content validity of the scale is better when CVR is greater than 0.8.The results showed that the parameters of blood coagulation risk assessment in cardiopulmonary bypass were highly correlated with the risk factors of blood coagulation in vitro.Conclusion1? With no heparin hemodialysis patients with blood coagulation risk factors as a theoretical basis,through literature search,expert Consultation,group discussion and hierarchical analysis,can be developed without heparin hemodialysis risk assessment scale,as a risk assessment tool.2?The risk assessment scale of non-heparin hemodialysis patients,which covers 4 first-level indexes and 19 two-level indexes,is scientific and practical,can objectively,truly and effectively reflect the risk factors of blood coagulation at cardiopulmonary bypass,and provides a reference for risk management of patients without heparin hemodialysis. |
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