Development of a preventive intervention program for lower limb lymphedema after gynecological malignant tumor surgery based on the health action process approach theory
基于健康行动过程取向理论的妇科恶性肿瘤术后下肢淋巴水肿预防干预方案构建

摘要

目的 基于健康行动过程取向（HAPA）理论，构建妇科恶性肿瘤术后下肢淋巴水肿预防干预方案，为临床开展针对性预防护理提供参考。方法 运用HAPA理论框架，通过文献研究、质性访谈拟定方案初稿，采用德尔菲法经过2轮专家函询确定妇科恶性肿瘤术后下肢淋巴水肿预防干预方案。结果 2轮专家函询的积极系数均为100%，权威系数为0.92，第二轮函询的各级指标肯德尔和谐系数为0.35~0.58（P<0.05）；最终方案包括3个一级指标、8个二级指标、22个三级指标。结论 以健康行动过程取向理论构建的妇科恶性肿瘤术后下肢淋巴水肿预防干预方案符合临床需求，可为降低术后下肢淋巴水肿发生率、改善患者生活质量提供标准化干预工具。

Abstract

Objective Based on the Health Action Process Approach (HAPA) theory, a preventive intervention program for lower limb lymphedema after gynecological malignant tumor surgery was developed to provide a reference for targeted preventive nursing in clinical practice.
Methods Using the HAPA theoretical framework, the initial draft of the protocol was formulated through literature review and qualitative interviews, and finalized via two rounds of Delphi expert consultations.
Results The positive coefficients in both rounds of expert consultations were 100%, with an authority coefficient of 0.92. The Kendall’s coefficient of concordance for each level of indicators in the second round ranged from 0.35 to 0.58 (P<0.05). The final protocol included 3 primary indicators, 8 secondary indicators, and 22 tertiary indicators.
Conclusion   The preventive intervention protocol for postoperative lower extremity lymphedema in gynecological malignancies, constructed based on the Health Action Process Approach theory, meets clinical needs and provides a standardized intervention tool to reduce the incidence of postoperative lymphedema and improve patients’ quality of life.