基于结构-过程-结果三维质量模型构建老年患者身体约束护理质量评价指标体系

Construction of an evaluation index system for the quality of physical constraint care for elderly patients based on a three-dimensional quality model of structure-process-outcome

目的构建老年患者身体约束护理质量评价指标,为临床评价老年患者身体约束护理质量提供参考依据,以降低老年患者身体约束率。方法以"结构-过程-结果"三维质量模型为理论基础,结合文献回顾和理论分析,建立老年患者身体约束护理质量评价指标初稿。采用便利抽样法,于2022年5—8月选取17名专家进行德尔菲函询,并通过层次分析法确定老年患者身体约束护理质量评价指标及其所占权重。结果共进行2轮函询,问卷有效回收率分别为88.24%(15/17)、100.00%(15/15),专家权威系数均为0.97,肯德尔和谐系数分别为0.34、0.39(P<0.05)。最终形成包括3个一级指标、15个二级指标和34个三级指标的老年患者身体约束护理质量评价指标体系。结论本研究构建的老年患者身体约束护理质量评价指标内容科学、可靠、全面,具有针对性,可为衡量老年患者身体约束护理质量提供参考依据。

Objective To construct an evaluation index system for the quality of physical constraint care for elderly patients,providing a reference basis for clinical evaluation of the quality of physical constraint care for elderly patients,so as to reduce the rate of physical restraint in elderly patients.Methods Based on the three-dimensional quality model of"structure-process-outcome",combined with literature review and theoretical analysis,a preliminary draft of an evaluation index system for the quality of physical constraint care for elderly patients was established.From May to August 2022,17 experts were selected by convenience sampling for Delphi consultation.The evaluation indicators and their weights for the quality of physical restraint care for elderly patients were determined using the analytic hierarchy process.Results Two rounds of consultation were conducted,and the effective response rates of the questionnaire were 88.24%(15/17)and 100.00%(15/15),respectively.The expert authority coefficients were 0.97,and the Kendall harmony coefficients were 0.34 and 0.39(P<0.05).The final evaluation index system for the quality of physical constraint care for elderly patients included 3 first-level indicators,15 second-level indicators,and 34 third-level indicators.Conclusions The content of the evaluation index system for the quality of physical restraint care for elderly patients constructed in this study is scientific,reliable,comprehensive,and targeted,which can provide a reference basis for measuring the quality of physical restraint care for elderly patients.