基于安宁疗护视角下舒适照护实践能力评价指标的构建

Construction of Evaluation Index of Comfortable Nursing Practice Ability Based on the Perspective of Hospice Care

目的:构建舒适照护临床实践能力评价指标体系,减轻患者痛苦、提高舒适度,预防并发症。同时,对安宁疗护临床实践技能培训与考核及开展规范舒适照护提供质量评价依据。方法:本研究采用文献研究、理论研究、临床调研的方法初步拟定质量标准指标,应用德尔菲法对30名护理专家进行问卷调查咨询,收集并使用层次分析法、半结构式深入访谈法进行筛选和论证,制定各指标的权重。结果:通过两轮的专家函询应答率为100%,专家的信度检验系数α值>0.8,CR=CI/RI<0.10,一级指标的协调系数为0.321、二级指标的协调系数为0.363、三级指标的协调系数为0.317,三项指标的协调系数值(P<0.001),最终确定一级指标4项、二级指标17项、三级指标77项的舒适照护实践能力评价指标体系。结论:通过使用德尔菲法所得到的专家信息准确,专家信度校验值高,最后所形成的舒适照护实践能力评价指标体系可以对安宁疗护临床实践技能培训与考核及开展规范舒适照护提供质量评价依据。

Objective: To establish an evaluation index system for the clinical practice ability of comfortable care to alleviate patient suffering, improve comfort, and prevent complications. To provide quality evaluation basis for the training and assessment of clinical practice skills in hospice care and the development of standardized and comfortable care. Methods: The methods of literature research, theoretical research, and clinical investigation were used to preliminarily draw up quality standard indicators, and the Delphi method was used to conduct questionnaire surveys and consultations with 30 nursing experts. The analytic hierarchy process and the semi-structured in-depth interview method were collected and used to screen and demonstrate, and to formulate the weight of each indicator. Results: After two rounds of expert letter inquiries, the response rate was 100%, and the expert’s reliability test coefficient α>0.8, CR=CI/RI<0.10. The coordination coefficient of the first-level index was 0.321, the coordination coefficient of the second-level index was 0.363, the coordination coefficient of the third-level index was 0.317, and the coordination coefficient value of the three indexes(P<0.001). Finally, an evaluation index system for comfort care practical ability was determined with 4 first-level indicators, 17 second-level indicators, and 77 third-level indicators. Conclusion: The expert information obtained by using the Delphi method is accurate and the expert reliability check value is high. The final evaluation index system of comfort care practice ability formed can provide quality evaluation basis for the training and assessment of clinical practice skills of comfort care and the development of standardized comfort care.