基于PICO 的艾滋病中医临床问题设置专家问卷的构建与结果分析
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R512.91

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国家自然科学基金项目(81660771,81673828);全国中医药创新骨干人才培训项目(国中医药办人教函[2019]91号);广西第二批 广西医学高层次骨干人才培养“139”计划项目(桂卫科教发[2018]22号);广西中医药适宜技术开发与推广项目(GZSY21-34)


Analysis of Construction and Results of Expert Questionnaire About Clinical Problems of Chinese Medicine for AIDS Based on PICO Model
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    摘要:

    目的:按照《艾滋病中医临床实践指南》的工作要求,进行临床问题设置专家问卷的调查问卷设计,收集、分析《基于PICO 的艾滋病中医临床问题设置专家问卷》调查结果,确定拟开展文献评价的临床问题。方法:在现有的中西医治疗艾滋病指南、规范、专家经验、文献等的基础上,确定临床问题条目池,召开专家咨询会对问题筛选进行论证,设计问卷初稿,经专家审核后,进行修改完善,确定最终调查问卷—— 《基于PICO 的艾滋病中医临床问题设置专家问卷》,共设置14 个问题,其中专家信息问题6 个,临床问题筛选问题选择及排序题6 个,开放性问题2 个,使用腾讯问卷进行在线发放、回收,发放对象为艾滋病临床一线专家,然后对收集的数据进行分析。结果:回收有效问卷41 份,咨询专家男19 位(占46.3%)、女22 位(占53.7%);平均年龄(43.6±8.2) 岁;从事艾滋病临床工作时间平均(9.6±4.7) 年;职称中初级6 位(占14.6%),中级12 位(占29.3%),副高级15 位(占36.6%),正高级8 位(占19.5%);专业构成中医23 位(占56.1%),西医12 位(占29.3%),护理4 位(占9.8%),其他2 位(占4.9%);所在单位省级医院16 位(占39.0%),市级医院13 位(占31.7%),县级医院9 位(占22.0%),其他(高校) 2 位(占4.9%),疾控部门1 位(占2.4%)。综合临床常见问题、中医药(中西医结合) 治疗有优势病症、有较成熟的中医(中西医结合) 治疗方案、可以纳入指南病症、可以使用中医药非药物治疗方法病症等问题,纳入指南建议病种为如下14 种:艾滋病疲乏、艾滋病食欲不振、艾滋病腹泻、艾滋病免疫重建功能不良、艾滋病带状疱疹、艾滋病咳嗽、艾滋病发热、艾滋病皮疹、艾滋病感冒、艾滋病失眠、老年艾滋病病毒(HIV) 感染、艾滋病肝功能损伤、HIV 感染者、艾滋病抑郁。结局指标重要性排序位列前T 淋巴细胞等免疫功能(CD4+、CD8+计数,CD4+/CD8+比值等)、症状体征(症候群) 减轻或消失、生存质量、HIV 载量、生存时间、观察病症的发病率、死亡率、所观察病症的卫生经济学指标等。结论:《基于PICO 的艾滋病中医临床问题设置专家问卷》的问卷较好的筛选出了艾滋病常见的14 个临床问题,结局指标,为后续文献评价提供指导。

    Abstract:

    Abstract: Objective: According to the requirements of Clinical Practice Guidelines of Chinese Medicine for AIDS, to design the expert questionnaire about clinical problems,to collect and analyze the questionnaire results,and to determine the clinical problems that are intended to be given literature evaluation. Methods: On the basis of the existing guidelines, norms,expert experience and literature on the treatment of AIDS in Chinese and western medicine,we determined the item pool of clinical problems,held an expert consultation meeting to demonstrate the selection of problems,designed the first draft of the questionnaire, revised and improved it after the review by experts, and determined the final questionnaire, namely Expert Questionnaire about Clinical Problems of Chinese Medicine for AIDS Based on PICO Model. A total of 14 questions were set in the questionnaire, including 6 questions about expert information, 6 multiple- choice and sequencing questions about clinical and sieving problems,and 2 open questions. Tencent Questionnaire was used for online distribution and collection, and the distribution objects were clinical experts for AIDS, and then the collected data were analyzed. Results:A total of 41 valid questionnaires were collected,and the consultant experts included 19 males(46.3%) and 22 females(53.7%). The average age of the experts was 43.6±8.2 years old,and the average time of their clinical work on AIDS was 9.6 ± 4.7 years. There were 6 experts with junior title(14.6% ), 12 intermediate(29.3% ), 15 deputy senior (36.6%),and 8 senior(19.5%). In terms of their majors,there were 23 experts majoring in Chinese medicine(56.1%),12 in western medicine(29.3%),4 in nursing(9.8%) and 2 in others(4.9%). When it comes to where they work,it turned out that 16 experts were working at provincial hospitals(39.0% ), 13 at municipal hospitals(31.7% ), 9 at county- level hospitals (22.0% ), 2 at universities(4.9% ) and 1 at disease control department(2.4% ). The following questions, including common clinical problems, Chinese medicine(integrated Chinese and western medicine) treatment of dominant diseases, diseases with more mature Chinese medicine(integrated Chinese and western medicine) treatment schemes, diseases that can be included in the guidelines and diseases that can be treated with non- drug treatment methods of Chinese medicine,being synthesized,the following 14 diseases could be included in the guidelines:AIDS fatigue,AIDS anorexia,AIDS diarrhea, AIDS immune reconstruction dysfunctions,AIDS herpes zoster,AIDS cough,AIDS fever,AIDS rash,AIDS cold,AIDS insomnia,elderly HIV infection,AIDS liver function damage,HIV infected people,and AIDS depression. The importance ordering of the outcome index includes immune function like T lymphocyte function(CD4 +,CD8 + count,CD4 +/CD8 + ratio, etc.),reduction or disappearance of symptoms and signs(syndromes),quality of life,HIV load,survival time,morbidity, mortality,and health economics indexes of the observed disease. Conclusion:Expert Questionnaire about Clinical Problems of Chinese Medicine for AIDS Based on PICO Model screens out 14 common clinical problems and outcome indicators of AIDS,and provides guidance for follow-up literature evaluation.

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姜枫,陈薇,刘振威,郑景辉,唐友明,宋策,刘建平.基于PICO 的艾滋病中医临床问题设置专家问卷的构建与结果分析[J].新中医,2021,53(8):194-200

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  • 在线发布日期: 2021-04-29
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