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预防医学  2022, Vol. 34 Issue (6): 631-636    DOI: 10.19485/j.cnki.issn2096-5087.2022.06.017
  妇幼保健 本期目录 | 过刊浏览 | 高级检索 |
应用德尔菲法构建乙型肝炎病毒感染孕产妇健康管理优化路径
周洋1, 卢肇骏2, 严睿1, 邓璇1, 唐学雯1, 朱瑶1, 徐校平1, 何寒青1
1.浙江省疾病预防控制中心免疫规划所,浙江 杭州 310051;
2.浙江中医药大学,浙江 杭州 310053
Construction of a path for optimizing the health management of HBV infections among pregnant and lying-in women based on a Delphi method
ZHOU Yang1, LU Zhaojun2, YAN Rui1, DENG Xuan1, TANG Xuewen1, ZHU Yao1, XU Xiaoping1, HE Hanqing1
1. Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China;
2. Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
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摘要 目的 应用德尔菲法构建乙型肝炎病毒(HBV)感染孕产妇健康管理优化路径,为加强乙肝母婴阻断提供依据。方法 查阅文献并结合前期相关研究,初步构建HBV感染孕产妇健康管理优化路径框架和内容。选择流行病学、临床医学和妇幼保健学方面的专家开展两轮德尔菲咨询,对初步设计的指标进行筛选和修改;根据指标的可行性得分,采用比例分配法确定指标权重。结果 参与咨询的专家16人,其中女性13人;年龄为(45.69±5.71)岁;从业(23.06±7.05)年;均为本科及以上学历;副高级及以上职称14人。两轮专家平均积极程度为96.88%,权威系数为0.790,各级指标的重要性、必要性和可行性的协调系数均有统计学意义(P<0.05),可行性的变异系数均<0.250。最终形成了包含6个一级指标、17个二级指标和73个三级指标的HBV感染孕产妇健康管理优化路径;一级指标中,“分娩管理”(0.173 4)、“筛查与评估”(0.172 8)和“妊娠期管理”(0.172 7)的权重较高。结论 构建的HBV感染孕产妇健康管理优化路径较为科学和可靠,对于进一步加强乙肝母婴阻断具有一定应用价值。
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周洋
卢肇骏
严睿
邓璇
唐学雯
朱瑶
徐校平
何寒青
关键词 乙型肝炎病毒母婴传播健康管理德尔菲法    
AbstractObjective To establish an optimized path for health management of HBV infections among pregnant and lying-in women based on a Delphi method, so as to provide the evidence for intensifying the interruption of the mother-to-child transmission of HBV. Methods Based on literature review and previous studies, the preliminary framework and contents of the optimized path for health management of HBV infections were constructed. Experts from epidemiology, clinical medicine and maternal and children healthcare were invited to participate in two-round Delphi consultations, and the preliminarily designed indicators were screened and revised. The score for feasibility of each indicator was calculated, and the weight of each indicator was estimated using a proportional distribution method. Results Sixteen experts participated in the consultation, including 13 women. The participants had a mean age of (45.69±5.71) years, and a mean employment duration of (23.06±7.05) years. All participants had a degree of bachelor and above, and there were 14 experts with vice senior professional titles. The mean positive coefficient was 96.88% and the mean authority coefficient was 0.790 during the two-round expert consultations. There were significant differences in the coordination coefficient of importance, necessity and feasibility of indicators at all levels (P<0.05), and the coefficient of variation of the feasibility was all less than 0.250. The final optimized path for health management of HBV infections among pregnant and lying-in women included 6 primary indicators, 17 secondary indictors and 73 tertiary indicators. Among the primary indicators, delivery management (0.173 4), screening and evaluation (0.172 8) and pregnancy management (0.172 7) had a high weight. Conclusion A scientific and reliable optimized path is created for health management of HBV infections among pregnant and lying-in women, which has a potential value for improving the interruption of mother-to-child transmission of HBV.
Key wordshepatitis B virus    mother-to-child transmission    health management    Delphi method
收稿日期: 2022-03-25      修回日期: 2022-04-21      出版日期: 2022-06-10
中图分类号:  R512.6  
基金资助:浙江省医药卫生科技计划面上项目计划(2020KY519); 中国乙肝防控科研基金(YGFK20200055)
作者简介: 周洋,硕士,主管医师,主要从事疫苗针对性疾病监测与评价工作
通信作者: 何寒青,E-mail:hanqinghe@cdc.zj.cn   
引用本文:   
周洋, 卢肇骏, 严睿, 邓璇, 唐学雯, 朱瑶, 徐校平, 何寒青. 应用德尔菲法构建乙型肝炎病毒感染孕产妇健康管理优化路径[J]. 预防医学, 2022, 34(6): 631-636.
ZHOU Yang, LU Zhaojun, YAN Rui, DENG Xuan, TANG Xuewen, ZHU Yao, XU Xiaoping, HE Hanqing. Construction of a path for optimizing the health management of HBV infections among pregnant and lying-in women based on a Delphi method. Preventive Medicine, 2022, 34(6): 631-636.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2022.06.017      或      http://www.zjyfyxzz.com/CN/Y2022/V34/I6/631
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