Construct Self Management For Low Anterior Resection Syndrome Of Rectal Cancer Based On Symptom Management Theory

Research Purpose:Based on the literature search on the related symptom management and self-management of low rectal resection syndrome of rectal cancer,our group discussed the related items that meet the symptom management and self-management of low rectal resection syndrome,then formed a preliminary self-management plan for low anterior rectal resection syndrome.Based on the Delphi method,the expert opinions were discussed and modified to form the final self-management plan for low anterior resection syndrome.We provide reference for patients with low anterior resection syndrome which will benefit to improve their self-management ability and quality of life.Research Methods:(1)Literature research: We comprehensively searched relevant literature on symptom management and self-management of low anterior rectal resection syndrome through Pub Med,Cochrane library,Embase,Web of Science,CINAHL,China Journal Literature Database(CNKI),China Biomedical Literature Database(CBM),Wanfang Database and Vip Full-text Database.The content analysis method was used to identify and extract the relevant items of symptom management and self-management of low anterior resection syndrome.Followed by group discussion,we removed the rough and preserved the essence,and formed a preliminary draft of the self-management of low anterior resection syndrome.(2)Expert letter inquiries: This research conducted a total of two rounds of Delphi expert letter inquiries.During the construction process,the experts were highly motivated and authoritative.We discussed and revised the items according to the experts’ suggestion.A self-management plan for low anterior rectal resection was finally constructed based on symptom management theory.Research Results:(1)Literature research: Large number of literatures were consulted in this study.Through literature preliminary screening and rescreening,18 literatures which were closely related to symptom management and self-management of low anterior resection of rectum were selected.Literature extraction results showed that strengthening self-management can be used to improve the quality of life of patients with low anterior resection syndrome.(2)Expert letter inquiries: A total of 17 clinical experts participated in the consultation.After two rounds of consultation the questionnaire recovery rate was 100%,which reflecting their high enthusiasm.The Cr-value of expert authority in the first round was 0.78,and reached 0.89 in the second round.It indicated that the result of the inquiry was highly credible.The concentration degree of expert opinions was expressed by variation coefficients(CV)and Kendall coordination coefficient.The CV-value of importance and operability in the first round of Delphi inquiry items were0.02～0.65 and 0.01～0.43,respectively.After the second round of expert consultation,the opinions of different items were significantly reduced,while the calculation results of CV were also significantly reduced compared with the previous round.The statistical results showed that the CV-value of the importance and operability of items were 0 ～ 0.23 and 0.01 ～ 0.12,respectively.It indicated that the opinions of experts in the two rounds of consultation were relatively concentrated.The W-value in the first round of expert consultation was 0.104,and the W-value after the second round was 0.437.With the statistical significance test of P < 0.05,our results showed that the experts’ opinions on each item have a good concentration.Research Conclusion:In this study,literature research method was used to extract the related literature on self-management and symptom management of low anterior resection syndrome.We selected the specific indicators and implementation points of self-management scheme of low anterior resection syndrome,and formed the self-management scheme of patients with low anterior resection syndrome combined with the results of expert consultation.