临床视角下代谢综合征患者健康素养评价指标体系研究

Health Literacy Evaluation Index System for Patients With Metabolic Syndrome From Clinical Perspective

目的从临床视角出发,研究构建代谢综合征（MS）患者健康素养评价指标体系。方法在文献研究、理论分析、专题小组讨论的基础上,采用德尔菲专家咨询法进行两轮咨询。选择我国7个行政区域的咨询专家26人,将咨询问卷以E-mail方式寄给专家,专家对指标的重要性和可操作性进行打分。采用百分位数法,联合运用满分比、均数及变异系数对指标进行筛选,同时结合专家意见,经课题组集体评议后进行指标筛选结果的确认,最终确定临床视角下MS患者健康素养评价指标体系。结果本研究共进行了两轮专家咨询,第一轮问卷回收率为100.00%,第二轮问卷回收率为92.31%。第一轮所有一级指标和二级指标的重要性得分均数为3.69-4.96,可操作性得分均数为3.15-4.69;第二轮重要性得分均数为4.21-4.95,可操作性得分均数为4.33-4.70。第一轮重要性变异系数为0.04-0.30,可操作性变异系数为0.15-0.37;第二轮重要性变异系数为0.04-0.22,可操作性变异系数为0.09-0.16。第一轮重要性、可操作性的协调系数分别为0.406、0.383;第二轮分别为0.580、0.430。第一轮熟悉程度系数为0.867,判断依据系数为0.935,权威程度为0.901;第二轮熟悉程度系数为0.841,判断依据系数为0.896,权威程度为0.869。根据专家咨询结果,构建了一套由5个一级指标和30个二级指标构成的指标体系,5个一级指标分别为：健康信息获取和理解能力、与医生沟通和交流能力、健康行为与技能、健康知识与意愿、自我效能。结论本研究确定了临床视角下MS患者健康素养评价指标体系,专家积极系数、权威程度、专家意见的协调程度均满足预测要求。

Objective To research and build a health literacy assessment index system for patients with metabolic syndrome（ MS） from clinical perspective. Methods Based on literature research, theoretical analysis and focus group discussion,we conducted a two-round consultation with 26 experts from seven administrative regions in China by Delphi expert consultation method. Consultation questionnaires were sent to experts by E-mail, and the importance and operability of the indexes were rated by the experts. The indexes were selected using percentile method combined with full mark ratio,mean and variable coefficient; based on expert opinions,the result of index selection was confirmed through group discussion within the research team. Then,the health literacy evaluation index system for MS patients from clinical perspective was determined. Results In the two-round expert consultation,the recovery rates of the first round and the second round were 100. 00% and 92. 31%respectively. In the first round,the mean score of importance of all primary indexes and all secondary indexes was 3. 69 - 4. 96,and the mean score of operability was 3. 15 - 4. 69; in the second round,the mean score of importance was 4. 21 - 4. 95,and that of operability was 4. 33 - 4. 70. The variable coefficients of importance and operability of the first round and the second round were 0. 04 - 0. 30 and 0. 15 - 0. 37 respectively; the variable coefficients of importance and operability of the first round and the second round were 0. 04 - 0. 22 and 0. 09 - 0. 16 respectively. The coordinate coefficients of importance and operability of the first round were 0. 406 and 0. 383,and those of the second round were 0. 580 and 0. 430. In the first round,the coefficients of degree of familiarity, judgment basis and the degree of authority were 0. 867, 0. 935 and 0. 901; in the second round, these coefficients were 0. 841,0. 896 and 0. 869. According to expert consultation results, an index system made up of 5 primary indexes and 30 secondary indexes was built,and the 5 primary indexes were the ability of health information acquisition and comprehension,the ability of communication with doctors,health behaviors and skills,health knowledge and will,and self-efficacy. Conclusion A health literacy assessment index system for MS patients from clinical perspective is determined in this study; the positive coefficients,the degree of authority and the expert opinion coordination degree all meet with the predictive demand.