老年人及慢性病病人访视护理评估工具的研究

Study on visit nursing assessment tools of the elderly and chronic diseases patients

[目的]研制一套规范化的老年人及慢性病病人访视护理评估工具。[方法]采用文献分析、专家访谈、问卷调查及现场试用等综合方法,以奥马哈系统为理论评估框架,结合国情筛选及确立评估内容;便利抽取4个社区服务中心居家老年慢性病病人试用该评估工具并对信度及效度进行检验。[结果]研制的评估表由访视护理问题评估、访视护理干预需求评估及访视护理简要记录3部分组成;8个评估条目Cohen’s Kappa值均>0.4,显示良好的评估员间信度水平;16名(100.0%)评估员认为该工具可规范健康问题、症状干预及护理记录的管理,内容科学、全面、简明;14名(87.5%)评估员对工具的实用性方面持肯定态度。[结论]老年人及慢性病病人访视护理评估工具内容科学、全面、简明,具有较好的实用性,可用于居家老年人及慢性病病人的规范化护理评估。

Objective：To develop a set of standard visiting nursing assessment tools for the elderly and chronic diseases patients.Methods：The literature analysis,expert interview,questionnaire survey and field trial and other comprehensive methods were used,taking Omaha system as a theoretical evaluation framework and combining with the national conditions to screen and establish evaluation content.The home elderly patients with chronic disease were extracted in 4community service centers and to try the evaluation tool and test its reliability and validity.Results：The developed assessment tool comprised of visit nursing problems assessment,visit nursing intervention demand assessment and visit nursing simple record.The Cohen Kappa value of all eight assessment items 〉0.4and it showed good reliability levels among assessors.As to the evaluation of this tool,16（100.0%）assessors thought this tool could standardize the management of health problems,symptoms intervention and nursing records.It was a scientific,comprehensive and concise tool.14（87.5%）assessors had positive attitude towards the practicability of the tool.Conclusion：This visit nursing evaluation tool has comprehensive,concise and scientific content and has better practicability.It can be used for the standardized nursing assessment of the home elderly and chronic patients.