Construction and application of discharge preparation service plan for caregivers of patients with moderate to severe craniocerebral injury
中重型颅脑损伤患者照顾者出院准备服务方案的构建及应用

摘要

目的 构建中重型颅脑损伤（MS-TBI）患者照顾者出院准备服务方案，并探讨其临床应用效果。方法 通过文献研究并经质量评价初建方案，邀20位多学科专家以德尔菲法两轮函询优化形成终稿。选取2024年1月到2025年6月某三级医院神经外科138例MS-TBI患者照顾者，按病区分为干预组（70例）与对照组（68例），对照组行常规健康教育，干预组应用构建方案（院内干预贯穿住院全程），比较两组照顾者干预前后照顾者准备度（主要指标）及其他相关指标。结果 方案经文献研究与两轮德尔菲函询构建，含4个主题、44项条目，专家函询相关系数均达标，意见一致。临床应用中，干预组与对照组均有少量病例脱落，干预后干预组照顾者准备度显著提升，照顾能力增强、焦虑减轻、生活质量提高，患者日常生活能力与认知能力也明显改善，各项指标组间差异均有统计学意义，证实该中重型颅脑损伤患者照顾者出院准备服务方案科学可行，效果显著。结论 构建的方案科学可行，贯穿住院全程的干预可显著提升照顾者准备度，改善照顾者与患者结局，具临床推广价值。

Abstract

Objective To construct a discharge preparation service program for caregivers of patients with moderate to severe craniocerebral injury (MS-TBI) and explore its clinical application effect.
Methods Through literature research and quality evaluation, an initial plan was established. Twenty multidisciplinary experts were invited to optimize it in two rounds using the Delphi method to form the final draft. From January 2024 to June 2025, 138 patients with MS-TBI and their caregivers in the neurosurgery department of a tertiary hospital were selected and divided into the intervention group (70 cases) and the control group (68 cases) according to the wards. The control group received routine health education, while the intervention group applied the construction plan (in-hospital intervention throughout the hospitalization process). Compare the caregiver readiness (the main indicator) and other related indicators before and after the intervention.
Results The plan was constructed through literature research and two rounds of Delphi inquiries, covering 4 themes and 44 items. The relevant coefficients of the expert inquiries all met the standards, and the opinions were consistent. In clinical application, both the intervention group and the control group had a small number of cases dropped out. After the intervention, the preparedness of caregivers in the intervention group was significantly improved, their care ability was enhanced, anxiety was reduced, and the quality of life was improved. The daily living ability and cognitive ability of patients were also significantly improved. The differences in each indicator between the groups were statistically significant. It was confirmed that the discharge preparation service plan for caregivers of patients with moderate to severe craniocerebral injury was scientifically feasible and highly effective.
Conclusion   The constructed plan is scientifically feasible. The intervention throughout the entire hospitalization process can significantly enhance the preparedness of caregivers, improve the outcomes of caregivers and patients, and has clinical promotion value.