妊娠期糖尿病患者健康素养评价指标体系的构建及验证

Establishment and application of an evaluation index system for health literacy among gestational diabetes mellitus patients

目的构建科学、系统的妊娠期糖尿病(gestational diabetes mellitus,GDM)患者健康素养评价指标体系并进行初步验证,为客观评价GDM患者健康素养水平,开展针对性的健康教育提供参考。方法基于文献分析、半结构式访谈、专家咨询法及层次分析法,确定GDM患者健康素养评价指标体系的内容及各指标权重。采用便利抽样法,于2022年3月选取青岛市某三级甲等医院的15例GDM患者和15名产科医护人员为研究对象,通过半结构式访谈对构建的评价指标体系进行初步验证。结果2轮咨询的有效问卷回收率分别为100%、94.74%,专家权威系数分别为0.924、0.942,肯德尔和谐系数分别为0.123~0.154、0.312~0.327(P<0.01)。最终形成的评价指标体系包括7项一级指标、49项二级指标。86.7%的GDM患者认为构建的指标体系内容明确、清晰,通俗易懂,对于日常自我管理具有指导性;100%的产科医护人员对指标体系的制订较满意,认为内容全面,专业性强,具有适用性和应用必要性。结论该研究构建的GDM患者健康素养评价指标体系合理、科学、可靠,指标内容具有专科性和特异性,符合GDM患者生理和心理特点。

Objective We aimed to establish an evaluation index system for health literacy among gestational diabetes mellitus(GDM)patients.As a theoretical basis,this system can be applied by the clinical nurses to carry out targeted health guidance among GDM patients and to evaluate health literacy level.Methods Initial indexes were generated through the literature review and semi-structured interviews.2 rounds of expert consultations and analytic hierarchy process were conducted to establish the evaluation index for health literacy among GDM patients.The convenience sampling method was used to select 15 GDM patients and 15 obstetric medical staff members from a tertiary A hospital in Qingdao as the research subjects in March 2022,and the application effect of the constructed evaluation index system was preliminarily verified by semi-structured interviews.Results The response rates of the 2 rounds of expert consultations are 100%and 94.74%.The expert authority coefficients are 0.924 and 0.942,respectively.The Kendall harmony coefficients of the 2 rounds of expert consultations are 0.123~0.154 and 0.312~0.327(P<0.01).As a result,we built up an evaluation index system of health literacy which comprised 7 first-level indexes,49 second-level indexes for GDM patients.86.7%of GDM patients thought that the content of index system was clear,easy to understand,and instructive for daily self-management.100%of obstetric medical staff were satisfied with the index system,and thought that the content was comprehensive,professional,with applicability and necessity of application.Conclusion The evaluation index system for health literacy among GDM patients is reasonable,scientific and reliable.The index content is specialized and specific,in line with the physical and psychological characteristics of GDM patients.