中医护理门诊护理质量评价指标体系的构建研究

Construction of nursing quality evaluation index system for nurse-led traditional Chinese medicine clinic

目的构建中医护理门诊护理质量评价指标体系,为评价中医护理门诊护理质量提供工具。方法以Donabedian的"结构-过程-结果"三维质量模型为理论框架,通过文献回顾并采用约翰霍普斯金循证护理实践模型的证据等级与质量评价标准进行文献质量评价,结合半结构式访谈形成初始指标条目;运用德尔菲法进行2轮专家函询,最终确定指标体系;通过层次分析法计算指标权重。结果2轮专家函询问卷的有效回收率分别为95.65%(22/23)和86.36%(19/22),专家权威系数为0.80和0.81;2轮专家函询结果各级指标的变异系数分别为0.043~0.326、0.000~0.215,肯德尔协调系数为0.261和0.214,差异有统计学意义(均P<0.05);最终形成的指标体系包括一级指标3个,二级指标9个,三级指标53个。结论构建的中医护理门诊护理质量评价指标体系具有较好的可靠性,可为中医护理门诊护理质量评价提供参考。

Objective To construct the evaluation index system of nursing quality in nurse-led Traditional Chinese Medicine(TCM)clinic,and to provide a tool for evaluation of nursing quality in nurse-led TCM clinic.Methods Based on Donabedian three-dimensional quality model of"struction-process-outcome"the inital index system of nurse-led TCM clinic was formed through literature review,evidence level and quality evaluation were conducted based on Johns Hopkins evidence-based nursing method.Through 2 rounds of experts′consultation,the index system was finally determined.The index weight was calculated by analytic hierarchy process.Results Two rounds of experts consultations resulted in the effective response rate of 95.65%(22/23)and 86.36%(19/22),the expert authority coefficient was 0.80 and 0.81,coefficients of variation ranged from 0.043 to 0.326 and 0.000 to 0.215,and the Kendall coordination coefficient was 0.261 and 0.214,respectively,showing statistically significant difference(P<0.05 for both);the final indicator system consisted of 3 first-level indicators,9 second-level indicators and 53 third-level indicators.Conclusions The evaluation index system of nurse-led TCM clinic has good reliability,and can provide reference for the evaluation of nursing qualityin nurse-led TCM clinic.