目的：构建股骨头坏死的机器人辅助护理质量评价体系，填补临床机器人辅助护理质量评价的漏洞。方法：以参考文 献作为依据，以两轮 Delphi 法进行专家函询，借助量表问卷，经专家权威论证、指标增删改、专家协调后构建完整的股骨头 坏死的机器人辅助护理质量评价体系。结果：经过两轮函询，专家积极程度均为 100%，专家权威系数（Cr）由 0.744 上升 到 0.840，结果均大于 0.7，表明研究结果的可靠性。Kendall 协和系数由 0.245（P=0.091）上升到 0.270（P=0.025），表明专 家对评价指标由最先不一致性向一致性过渡。结论：通过两轮的 Delphi 法构建的股骨头坏死的机器人辅助护理质量评价体系， 以 Cr、变异系数（CV）等统计学分析为依据，有较高的科学性、可靠性及实用性。

Objective: To establish a quality evaluation system for robot-assisted nursing in osteonecrosis of the femoral head (ONFH), aiming to plug the loophole in clinical quality assessment of robot-assisted nursing. Methods: Based on literature evidence, a two-round Delphi method was employed to conduct expert consultations. Utilizing scaled questionnaires, a preliminary robot-assisted nursing quality evaluation system for osteonecrosis of the femoral head was established. This system underwent expert authority validation, iterative indicator refinement (addition/deletion/modification), and consensus coordination to ensure comprehensiveness. Results: After two rounds of consultation, expert participation remained 100%. The expert authority coefficient (Cr) increased from 0.744 to 0.840 (both >0.7), confirmed the reliability of the results. Kendall’s coefficient of concordance improved from 0.245 (P=0.091) to 0.270 (P=0.025), indicating a shift from initial inconsistency to consensus among experts on evaluation indicators. Conclusion: The robot-assisted nursing quality evaluation system for osteonecrosis of the femoral head, constructed through a two-round Delphi method, demonstrates high scientific validity, reliability, and clinical utility, as evidenced by expert authority coefficients, variation coefficients, and other statistical analyses.

基金项目：北京市科委首都临床特色应用研究项目（Z171100001017132）

Foundation Item: Beijing Municipal Committee of Science and Technology Capital Clinical Characteristic Applied Research Project  (Z171100001017132)  

引用格式：吴赞，王美玲，张媚 . 股骨头坏死的机器人辅助护理质量评价体系构建 [J]. 机器人外科学杂志（中英文），2025，6（4）： 578-584. 

Citation: WU Z, WANG M L, ZHANG M. Construction a quality evaluation system for robot-assisted nursing in osteonecrosis of the  femoral head[J]. Chinese Journal of Robotic Surgery, 2025, 6(4): 578-584. 

通讯作者（Corresponding Author）：张媚（ZHANG Mei），Email：120454911@qq.com

[1] 尚文涵 , 张海燕 , 么莉 , 等 . 护理专业医疗质量控制指标 (2020 年版 ) 的构建 [J]. 中国卫生质量管理 , 2021, 28(6): 66-69, 74. 

[2] 徐文超 , 邱贝贝 , 王孟瑶 , 等 . 基于医护人员视角机器人辅助下关节 置换手术质量评价的质性研究 [J]. 中华创伤骨科杂志 , 2022, 24(12): 1094-1099. 

[3] 屈会丽 , 王盛均 , 吴雨晨 , 等 . 近 10 年德尔菲法在护理领域应用的 可视化分析 [J]. 现代临床护理 , 2021, 20(4): 72-78. 

[4] 甘念 , 罗敏 , 吴丽芬 . 基于德尔菲法与层次分析法构建儿科门诊护理 质量评价体系 [J]. 护理实践与研究 , 2021, 18(10): 1573-1576. 

[5] 杨辰杰 , 陈瑛琦 , 周宁 , 等 . 基于洋葱模型的达芬奇机器人专科护 士岗位胜任力评价指标体系的构建 [J]. 中华现代护理杂志 , 2023, 29(33): 4494-4500. 

[6] 褚秀美 , 周海清 , 王明雪 , 等 . 基于加速康复外科理念下达芬奇机器 人肺叶切除术患者围手术期护理质量评价指标体系的构建 [J]. 中国 实用护理杂志 , 2020, 36(11): 823-828. 

[7] ZHAO D H, SUN X W, SHAN B, et al. Research status of elderly-care robots and safe human-robot interaction methods[J]. Front Neurosci, 2023. DOI: 10.3389/fnins.2023.1291682. 

[8] Lindblom J, Alenljung B. The ANEMONE: Theoretical foundations for UX evaluation of action and intention recognition in human-robot interaction[J]. Sensors (Basel), 2020, 20(15): 4284. 

[9] Gibelli F, Ricci G, Sirignano A, et al. The increasing centrality of robotic technology in the context of nursing care: bioethical implications analyzed through a scoping review approach[J]. J Healthc Eng, 2021. DOI: 10.1155/2021/1478025. 

[10] Soriano G P, Yasuhara Y, Ito H, et al. Robots and robotics in nursing[J]. Healthcare (Basel), 2022, 10(8): 1571. 

[11] LIAO G Y, HUANG T L, WONG M K, et al. Enhancing nurse-robot engagement: two-wave survey study[J]. J Med Internet Res, 2023. DOI: 10.2196/37731. 

[12] Ohneberg C, Stöbich N, Warmbein A, et al. Assistive robotic systems in nursing care: a scoping review[J]. BMC Nurs, 2023, 22(1): 72. 

[13] Mireles C, Sanchez M, Cruz-Ortiz D, et al. Home-care nursing controlled mobile robot with vital signal monitoring[J]. Med Biol Eng Comput, 2023, 61(2): 399-420. 

[14] Ahmad M I, Refik R.“No Chit Chat!”A warning from a physical versus virtual robot invigilator: which matters most?[J]. Front Robot AI, 2022. DOI: 10.3389/frobt.2022.908013. 

[15] Ohneberg C, Warmbein A, Stöbich N, et al. Study protocol for the implementation and evaluation of a digital-robotic-based intervention for nurses and patients in a hospital: a quantitative and qualitative triangulation based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions[J]. BMC Nurs, 2022, 21(1): 349. 

[16] Cavallo F, Esposito R, Limosani R, et al. Robotic services acceptance in smart environments with older adults: User satisfaction and acceptability study[J]. J Med Internet Res, 2018, 20(9): e264. 

[17] Forgas-Coll S, Huertas-Garcia R, Andriella A, et al. The effects of gender and personality of robot assistants on customers’ acceptance of their service[J]. Service Business, 2022, 16(2): 359-389. 

[18] Buchanan C, Howitt M L, Wilson R, et al. Predicted influences of artificial intelligence on the domains of nursing: scoping review[J]. JMIR Nurs, 2020, 3(1): e23939. 

[19] 徐文超 , 邱贝贝 , 王孟瑶 , 等 . 基于医护人员视角机器人辅助下关节 置换手术质量评价的质性研究 [J]. 中华创伤骨科杂志 , 2022, 24(12): 1094-1099. 

[20] 韩锦川 , 王子洪 , 周晟汀 , 等 . 达芬奇手术机器人系统的临床应用与 设备管理体系的建立与实践 [J]. 中国医疗设备 , 2023, 38(9): 111-116. 

[21] 王喆 , 王春灵 , 郭呈瑶 . 达芬奇机器人手术专科护士培训体系的构 建 [J]. 护理实践与研究 , 2023, 20(15): 2355-2359. 

[22] 杨辰杰 , 陈瑛琦 , 周宁 , 等 . 基于洋葱模型的达芬奇机器人专科护 士岗位胜任力评价指标体系的构建 [J]. 中华现代护理杂志 , 2023, 29(33): 4494-4500. 

[23] Ohneberg C, Stöbich N, Warmbein A, et al. Assistive robotic systems in nursing care: a scoping review[J]. BMC Nurs, 2023, 22(1): 72. 

[24] Seibert K, Domhoff D, Bruch D, et al. Application scenarios for artificial intelligence in nursing care: rapid review[J]. J Med Internet Res, 2021, 23(11): e26522.