基于德尔菲法筛选心肌梗死后心室重塑基本证候要素量表条目

Screening of Entries of Scale for Basic Syndrome Elements of Ventricular Remodeling after Myocardial Infarction with Delphi Method

目的:应用德尔菲法对心肌梗死后心室重塑基本证候要素量表的条目进行筛选。方法:基于德尔菲法对全国范围内的40名副高级以上职称医师进行有关心肌梗死后心室重塑基本证候要素的专家问卷调查,共进行两轮问卷调查。采用Microsoft Excel 2019及SPSS Statistics 24软件整理、统计数据,分析专家的基本信息和问卷结果,计算积极系数、权威程度、重要性均分、满分比、变异系数、Kendall系数、Cronbach′sα系数进行质量控制。结果:两轮专家问卷调查分别发放问卷40份及35份,回收35份及33份,专家积极系数分别为87.5%和94.3%。两轮专家权威程度分别为0.89和0.91。第2轮专家问卷调查结果显示,变异系数0.16,Kendall和谐系数为0.17,条目均分为3.94~4.85分,平均4.38分,满分比为0.30~0.54,平均满分比为0.53。问卷整体信度0.987。最终纳入心肌梗死后心室重塑9个基本证候(气滞证、血瘀证、痰浊证、水饮证、寒凝证、热蕴证、气虚证、阳虚证、阴虚证)、58个症状和体征(气短、乏力、畏寒、下肢水肿、活动后加重等)。结论:应用德尔菲法筛选得到的心肌梗死后心室重塑的9个基本证候要素、58个症状和体征条目,可为后期心肌梗死后心室重塑基本证候要素诊断量表的构建提供依据。

Objective:To screen the entries of scale for basic syndrome elements of ventricular remodeling after myocardial infarction with Delphi method.Methods:Based on the Delphi method,two rounds of expert-based questionnaire survey for syndrome elements of ventricular remodeling after myocardial infarction were conducted among nationwide physicians with associate chief physician or higher titles.Microsoft Excel 2019 and SPSS Statistics 24 software were used to organize and analyze the basic information of the questioned experts and the questionnaire results.The positive coefficient,expert authoritative coefficient,mean score,full score ratio,coefficient of variation,Kendall harmony coefficient,and Cronbach′sαcoefficient were calculated for quality control.Results:In the two rounds of expert questionnaire survey,40 and 35 questionnaires were issued respectively,and 35 and 33 were recovered.The expert positive coefficien were 87.5%and 94.3%respectively.The expert authoritative coefficient of the two rounds were 0.89 and 0.91 respectively.The results of the second round of expert questionnaire showed that the coefficient of variation was 16.3%,the Kendall coefficient was 0.17,the items were divided into 3.94 to 4.85,the average score was 4.38,the full score ratio was 0.30 to 0.54,the average full score ratio was 0.53.The overall reliability of the questionnaire was 0.987.Nine basic syndrome element entries(Qi stagnation syndrome,blood stasis syndrome,phlegm-retention,fluid-retention syndrome,cold stagnation syndrome,heat accumulation syndrome,Qi deficiency syndrome,Yang deficiency syndrome,Yin deficiency syndrome)and 58 symptoms and signs(shortness of breath,weakness,chills,lower limb edema,aggravation after activity,etc.)of ventricular remodeling after myocardial infarction were included.Conclusion:Nine basic syndrome element entries and 58 symptoms and signs of ventricular remodeling after myocardial infarction were screened by Delphi method,which can provide a basis for the construction of the diagnostic scale of basic syndrome element of ventricular remodeling after myocardial infarction.