基于质量三环理论构建肝硬化序贯治疗患者延续性护理评价指标体系

Construction ofa continuous nursing evaluation index system for patients with sequential treatment of liver cirrhosis based on Three Rings Theory of Quality

目的探讨质量三环理论构建肝硬化序贯治疗患者延续性护理的评价指标体系在临床评价肝硬化序贯治疗的应用价值。方法2020年2月至2021年4月中山大学附属第三医院消化内科以Donabedian提出的"结构-过程-结果"三环质量评价模式作为理论框架,通过文献研究、半结构访谈法初步构建延续性护理质量评价指标条目及初始专家咨询问卷,采用德尔菲法开展3轮专家咨询确定评价指标体系终稿。结果3轮专家问卷回收有效率均为100.0%,专家权威系数均为0.82,专家一致性系数Kendall’s W分别为0.158、0.161、0.224。最终形成一级指标3个,二级指标15个,三级指标49个的肝硬化序贯治疗患者延续性护理评价指标体系。结论基于质量三环理论构建肝硬化序贯治疗患者延续性护理的评价指标体系涵盖内容全面科学,专家对其意见高度集中,值得进一步深入临床研究。

Objective Based on the three-ring theory of quality,an evaluation index system of continuous care for patients with se⁃quential treatment of cirrhosis was established to provide a comprehensive,systematic and quantifiable standard for clinical evaluation of the quality of continuous care for patients with sequential treatment of cirrhosis.Methods From February 2020 to April 2021,the Department of Gastroenterology at the Third Affiliated Hospital of Sun Yat sen University used Donabedian's"Structure Process Result"three loop quality evaluation model as the theoretical framework.Through literature research and semi-structured interview methods,preliminary indicators for continuity of care quality evaluation were constructed,as well as an initial expert consultation questionnaire,and then the Delphi method was used to carry out three rounds of expert consultation to determine the final draft of the evaluation index system.Results The effective rate of the three rounds of expert questionnaires was 100.0%,the expert authority coefficient was 0.82,and the expert consistency coefficient Kend⁃all's W was 0.158,0.161,0.224,respectively.Establish a continuous nursing evaluation index system for liver cirrhosis patients undergoing se⁃quential treatment with 3 primary indicators,14 secondary indicators,and 46 tertiary indicators.Conclusions Building an evaluation index system for the continuity of care for patients undergoing sequential treatment of liver cirrhosis based on the quality three ring theory,covering comprehensive and scientific content,with highly concentrated opinions from experts,is worthy of further clinical research.