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基于德尔菲法的哺乳期乳腺炎手法通乳技术操作规范构建

Technical specifications operation of manual lactation technique based on Delphi method

摘要采用文献研究和德尔菲法,系统检索UpToDate、Cochrane Library、中国知识资源总库(CNKI)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)、中国生物医学文献服务系统(SinoMed)及网站,收集哺乳期乳腺炎手法通乳技术相关证据,采用临床指南研究与评价系统(AGREE Ⅱ)、系统评价方法学质量评价工具(AMSTAR 2)进行评价,对纳入证据进行分类汇总后形成技术操作规范的初稿。选择26名相关领域专家对初稿进行评价,根据筛选标准及专家意见删除和修改部分推荐意见,最终形成适用于医护人员的哺乳期乳腺炎手法通乳技术操作规范。本研究共纳入指南4篇、专家共识5篇、临床决策2篇、系统评价3篇,总体证据质量尚可。2轮专家函询各回收26份问卷,问卷回收率为100%,专家整体权威系数为0.91,形成的技术操作规范包括评估内容、适应证、禁忌证、操作方法、不良事件及处理方法等11个方面,共50条推荐意见。本技术操作规范内容全面,推荐意见表述清晰,符合临床真实情境,可为此技术临床实践提供有效参考。

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abstractsWe applied literature review and the Delphi method to develop technical operation of manual lactation technique. The databases and websites were systematically searched, such as UpToDate, the Cochrane Library, CNKI, VIP, Wanfang, and SinoMed. The evidence related to the technique was evaluated by Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ), and A Measure Tool to Assess Systematic Reviews 2 (AMSTAR 2). the included evidence was classified and summarized to form the preliminary draft of the technical operation specification. A total of 26 experts were selected to evaluate the draft, and some recommendations were deleted and modified according to the screening criteria and expert opinions, resulting in the final technical specifications for manual lactation technique applicable to health care professionals. The study included 4 guidelines, 5 expert consensus articles, 2 clinical decisions, and 3 systematic reviews, and the overall quality of the evidence was fair. A total of 26 questionnaires were collected in each of 2 rounds of expert consultation, with a 100% return rate and an overall authority coefficient of 0.91. The technical practice specification was formed in 11 aspects, including assessment content, indications, contraindications, operation methods, adverse events, and treatment methods, with a total of 50 recommendations. The technical operation specification is comprehensive, and the recommendations are clearly expressed, which is in line with the real clinical situation and can provide effective reference for the clinical practice of this technique.

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