基于Donabedian质量理论构建糖尿病合并冠心病护理质量评价指标体系的研究

Based on Donabedian quality theory,a study on the construction of a nursing quality evaluation index system for diabetes mellitus complicated with coronary heart disease

目的以Donabedian质量理论为支撑,构建糖尿病合并冠心病的护理质量指标体系,为临床系统且科学地管理糖尿病合并冠心病患者的护理工作及评价其护理质量提供可靠依据。方法以Donabedian质量模型为理论框架,基于文献回顾结合临床实践经验,初步拟定糖尿病合并冠心病的护理质量评价指标,在前期研究的基础上,通过2轮函询17名护理专家,全面了解各相关领域专家对于糖尿病合并冠心病护理质量评价的意见,进行层次分析及反复修改,最终确定糖尿病合并冠心病的护理质量评价指标。结果2轮专家函询,问卷回收率均及有效率为100%,专家权威系数Cr分别为0.834和0.853,专家意见的肯德尔和谐系数W(Kendall’s W)分别为0.368和0.399,W值经χ^(2)检验显示P<0.05,差异有统计学意义,说明专家意见逐渐趋于一致,专家协调程度较第1轮提高。最终形成的糖尿病合并冠心病的护理质量指标体系包含3个维度,13项一级指标及对应的26项二级指标。结论本研究构建的糖尿病合并冠心病患者的护理质量指标体系具有科学性及可靠性,能较为全面地衡量糖尿病合并冠心病的护理质量,为评价、改善其护理质量提供依据。

Objective To construct a nursing quality index system for patients with diabetes mellitus and coronary heart disease based on Donabedian quality theory,so as to provide a reliable basis for the systematic and scientific management of nursing work and evaluation of nursing quality of patients with diabetes mellitus and coronary heart disease.Methods Based on the theoretical framework of the Donabidian quality model,based on the literature review and clinical practice experience,the nursing quality evaluation index of diabetes mellitus complicated with coronary heart disease was preliminarily formulated,and on the basis of the previous study,through two rounds of consultation with 17 nursing experts,the opinions of experts in various related fields on the nursing quality evaluation of diabetes mellitus complicated with coronary heart disease were comprehensively understood,and the analytic hierarchy process and repeated revisions were carried out,and the nursing quality evaluation index of diabetes mellitus complicated with coronary heart disease was finally determined.Results In the two rounds of expert consultation,the recovery rate and effective rate of the questionnaire were 100%,the expert authority coefficients Cr were 0.834 and 0.853,and the Kendall's harmony coefficients were 0.368 and 0.399,respectively,and the W value showed byχ^(2)test,P<0.05,the difference was statistically significant,indicating that the expert opinions gradually converged,and the degree of expert coordination was higher than that in the first round.The final quality index system of diabetes mellitus combined with coronary heart disease nursing included three dimensions,13 first-level indicators and 26 corresponding second-level indicators.Conclusion The nursing quality index system for patients with diabetes mellitus and coronary heart disease constructed in this study is scientific and reliable,which can comprehensively measure the nursing quality of diabetes mellitus and coronary heart disease,and provide a basis for evaluating and improving the nursing quality.