Construction Of A Cognitive Intervention Program For ICU Nurses On Subsyndromal Delirium Based On Gagne’s Cognitive Learning Theory

Objective In this study,we are trying to explore and build a set of more scientific,reasonable and feasible cognitive intervention plan on subsyndromal delirium for ICU nurses,based on Gagne’s cognitive learning theory,through the Delphi expert consultation method.It can be used for ICU nurses’ cognitive intervention,aimed at improving ICU nurses’ cognitive level and nursing ability of subsyndromal delirium.Method 1.Through the literature study and group discussion,we mastered the research status and development trend of subsyndromal delirium at home and abroad;using the Gagne’s cognitive learning theory as the theoretical framework,we built a preliminary cognitive intervention plan on subsyndromal delirium for ICU nurses;After two rounds of Delphi expert consultation,the reliability and representativeness of expert consultation were verified by using indexes such as expert familiarity coefficient,positive coefficient,authority coefficient,variation coefficient and expert coordination coefficient.After careful analysis and arrangement of expert feedback,the final draft of ICU nurses’ cognitive intervention plan on subsyndromal delirium was finally formed after group discussion based on expert opinions.2.Using the method of convenience sampling,we choosed 21 ICU nurses in one grade 3 and first-class hospital in hangzhou,and divided them into control group and intervention group.In control group,small lectures and nursing ward rounds were used;in intervention group,the cognitive intervention plan on subsyndromal delirium based on Gagne’s cognitive learning theory was used.The intervention effects of two groups were compared,and the KABP model level before and after the intervention were compared using the self control study.Results 1.Through literature analysis,group discussion and other methods,the first draft of ICU nurses’cognitive intervention on subsyndromal delirium was constructed,after two rounds of Delphi expert consultation on the first draft of the plan for further optimization of the rectification,the final formation of ICU nurses’ cognitive intervention on subsyndromal delirium,including intervention objective,intervention content and curriculum setting,teacher arrangement and evaluation index.The individual authority coefficient was equal to or greater than 0.7,and the population coefficient was 0.886,two rounds of questionnaire recovery rate were 90%and 100%respectively,two rounds of expert advice rate were 80%and 22.2%respectively,the variation coefficient was 0.125±0.001 in the first round,the second round of the variation coefficient was 0.067±0.041,the Kendall’s W of two rounds have statistical significance(p<0.01),all of these indicating that the experts selected by this research institute have certain authority and professionalism,and have a high recognition of this research program.2.The cognitive intervention program for ICU nurses on subsyndromal delirium based on Gagne’s cognitive learning theory were used to test the intervention effect.Convenience sampling method was used to select 21 comprehensive ICU nurses for intervention.According to the scheduling of ICU,21 nurses were divided into control group and intervention group,and the two groups had baseline comparability(p>0.05).(1)Comparison results between the two groups after intervention:after intervention,ICU nurses in the two groups have differences in the evaluation of knowledge,belief and practice of subsyndromal delirium,and it was concluded that the two groups of ICU nurses have differences in the knowledge and behavior,and the difference is statistically significant(p<0.05),but there was no difference in attitude;After the intervention,there were differences in the theoretical and operational scores of ICU nurses between the two groups,and the differences were statistically significant(p<0.05).(2)Self-comparison results of the two groups before and after the intervention:the control group had no significant difference in the scores of subsyndromal delirium before and after the intervention(p>0.05);The scores of subsyndromal delirium before and after intervention were different in the intervention group,especially in the knowledge part and the behavior part(p<0.05).Conclusion 1.The cognitive intervention program for ICU nurse on subsyndromal delirium has rigorous structure,clear objectives and practical contents.The experts consulted by the research had a high recognition,and it was of certain practical value to carry out the cognitive intervention for ICU nurse on subsyndromal delirium clinically.2.This program took Gagne’s cognitive learning theory as the framework,and reasonably arranges the intervention content and method according to Gagne’s different requirements for each stage,which can effectively improve the ICU nurses’ cognitive level of subsyndromal delirium,improve the nursing ability for patients with subsyndromal delirium and improve the prognosis of patients in the and.