高职教师绩效考核体系设计——基于AHP和Delphi Method的综合运用

高职教师绩效考核的核心是教师工作业绩细化指标的设计,它的设计与教学改革相关性最大,基于AHP和Delphi Method的综合运用,从一级指标的权重看,教师科研工作业绩明显大于教学工作业绩;从二级指标看,教学研究与改革的重要性正逐步被认识;教学工作虽是衡量工作业绩的第一要素,但其内容已经丰富化,不再局限于课堂教学;教学政策的评定也更加多样化。

基于Delphi法构建手术室围术期低体温预防管理评价指标体系

目的 构建手术室围术期低体温预防管理评价指标体系。方法 2022年2月,以结构-过程-结果三维质量评价模式为理论框架,参考相关文献拟定手术室围术期低体温预防管理评价指标体系,采用德尔菲法对来自手术室护理管理、院内感染、麻醉领域的23名专家进行2轮专家函询,采用优序图法确定指标权重系数。结果 2轮专家函询的积极系数分别为100.0%和95.7%,专家权威系数分别为0.946和0.934,各项指标变异系数(CV)均<0.25,Kendall’s W值分别为0.419和0.359(均P<0.001),最终构建了包含3项一级指标、9项二级指标、53项三级指标的手术室围术期低体温预防管理评价指标体系。结论基于Delphi法构建手术室围术期低体温预防管理评价指标体系有较好的科学性和可靠性,可为手术室护理管理者提供参考,有利于临床开展科学、规范、统一的质量评价。

Outpatient Experience of Human Caring Scale （OEHC-Scale）： Improvement by Delphi Method

Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.

基于Delphi-AHP法的高职专业课教师课程思政能力评价指标体系建构

专业课教师的课程思政能力是高职院校全面推进课程思政工作的关键。针对高职专业课教师课程思政能力结构尚不明晰,评价体系粗放等问题,采用Delphi-AHP法构建高职专业课教师课程思政能力评价指标体系。通过文献三级编码、专家咨询和研究小组讨论,拟定高职专业课教师课程思政能力评价指标体系草案,然后经过两轮德尔菲(Delphi)专家咨询,确定了包含5个一级指标、17个二级指标和58个三级指标的评价指标体系,再采用层次分析法(AHP),构建各级指标判断矩阵,计算各指标权重并检验判断矩阵的一致性,确定各指标的合理权重。研究结果在理论上为探究高职专业课教师课程思政能力内涵拓展了新的认知视角,在实践上为高职院校教师课程思政能力测评提供了可操作的依据和方向。

基于Delphi法构建全科住院医师规范化培训教学查房细化评分量表

目的探索构建标准化全科住院医师规范化培训教学查房细化评分量表。方法采用焦点小组法组织从事全科医学工作10年以上的专家进行讨论,初步构建《全科住院医师规范化培训教学查房细化评分表》。然后,由10名全科教学查房指导专家,根据指标的重要性、可行性及专家的积极性、协调性等进行两轮Delphi问卷咨询。最后,运用层次分析法计算各级指标的权重,确定评价指标体系。结果共进行2轮焦点小组讨论,5名成员对各级指标进行讨论修改分类,初步建立教学查房评估指标体系。10名咨询专家共进行2轮问卷咨询,问卷回收率均为100%。第一轮、第二轮专家咨询的权威系数分别为0.93,0.97,协调系数Kendall’s W分别为0.522,0.421,P<0.001。根据两轮专家咨询结果构建7项一级指标、20项二级指标、119项三级指标,其中一级指标的权重分别为0.0327、0.0464、0.1599、0.2815、0.1599、0.1599、0.1599,所有指标判断矩阵的一致性比率CR均小于0.1。结论本研究构建的全科教学查房细化评分体系合理、完整、可操作性好,多维度反映查房教师及住院医师表现,可作为全科教学查房评价的参考依据。

Construction of the First Certification Evaluation Index System for Diabetes Specialist Nurses by Delphi Method

Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.

Delphi methodology in healthcare research:How to decide its appropriateness

The Delphi technique is a systematic process of forecasting using the collective opinion of panel members.The structured method of developing consensus among panel members using Delphi methodology has gained acceptance in diverse fields of medicine.The Delphi methods assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited,ethically/logistically difficult or evidence is conflicting.However,the attempts to assess the quality standard of Delphi studies have reported significant variance,and details of the process followed are usually unclear.We recommend systematic quality tools for evaluation of Delphi methodology;identification of problem area of research,selection of panel,anonymity of panelists,controlled feedback,iterative Delphi rounds,consensus criteria,analysis of consensus,closing criteria,and stability of the results.Based on these nine qualitative evaluation points,we assessed the quality of Delphi studies in the medical field related to coronavirus disease 2019.There was inconsistency in reporting vital elements of Delphi methods such as identification of panel members,defining consensus,closing criteria for rounds,and presenting the results.We propose our evaluation points for researchers,medical journal editorial boards,and reviewers to evaluate the quality of the Delphi methods in healthcare research.

基于Delphi+BSC导向的基层医疗机构医疗质量控制指标体系构建研究

目的:构建一套与基层医疗机构发展导向相适应、科学合理且能有效应用的医疗质量控制指标体系。方法:通过文献研究及政策文件分析筛选初始指标,借鉴平衡计分卡理论并运用德尔菲法构建质控指标体系及指标权重。结果:通过两轮专家咨询构建了基层医疗机构质量控制指标体系并得出了指标权重,包括4个一级指标、39个二级指标,专家积极系数、权威程度和意见协调程度均较好。结论:该指标体系对基层医疗机构医疗质量控制管理具有较高的科学性和可行性。如果辅以智慧医疗信息化平台的支撑,将能开展常态化推广运用,形成同质化质控管理模式。

Re-discussing the content of the prescription rights of midwives under certain circumstances using the Delphi method

Objective： This study sought to investigate the content of the prescription rights and the prescription types of midwives under certain circumstances in China. Methods： The Delphi method was used to consult 18 nursing experts and 14 medical experts, A total of 30 experts finished the consulting. The reliability of the expert opinions was analyzed to determine the specific situations in which midwives may write prescriptions, the content of the prescription rights and the prescription types. Results： In six specific circumstances （uterine contraction fatigue, uterine contractions that are too strong, postpartum hemorrhage, premature rupture of the membranes, normal delivery and neonatal asphyxia）, midwives have the right to prescribe and administer medication, including 20 drugs and 13 auxiliary examinations. Of these drugs and examinations, 51.5% of the drugs and adjuvant examination prescriptions tend to be independent prescriptions, 30.3% tend to be protocol prescriptions, and 18.2% are similar to both types. Conclusions： The midwives should be granted some prescription rights to enhance their autonomy and the professionalism of midwifery.

基于Delphi法的《中医妇科临床诊疗指南·妊娠恶阻》评价与修订

目的:修订妊娠恶阻中医临床诊疗指南。方法:检索2010年1月至2015年2月发表的关于中医药治疗妊娠恶阻的文献,结合文献研究,运用Delphi法进行3轮专家问卷调查,收集专家意见,统计专家积极系数和专家共识度,采用SPSS 19.0对专家熟悉程度、专家意见集中程度和专家意见协调程度进行计算,最后根据统计结果和专家咨询结果确定纳入条目。结果:共检出文献141篇,符合要求的高质量目标文献44篇。通过3轮问卷调查和专家论证会,对妊娠恶阻的术语和定义、诊断、辨证、治疗、预防和调护达成专家共识,最终形成妊娠恶阻中医诊疗指南修订征求意见稿。结论:本次妊娠恶阻修订稿较2012版相比修改了症状、辅助检查、治疗原则、针灸疗法部分,增加了预防与调摄,并对原指南的治法方药及中成药添加了文献依据及证据级别。

Development of an assessment and intervention protocol for postpartum hemorrhage in the mainland of China: an evidence-based method and Delphi consult

Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.

Study on traditional Chinese medicine syndrome of esophageal cancer based on Delphi method

Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal cancer is not standardized.This Delphi survey aimed to explore the TCM syndrome classification and symptom characteristics of esophageal cancer.Methods:Based on literature research,an expert consultation questionnaire was developed for the study of the TCM syndrome rules of esophageal cancer.Two rounds of questionnaire surveys were conducted among 62 experts across the country.Statistical description and statistical analysis of the mean,coefficient of variation,grade sum,and unimportant percentage of the retrieved data.TCM syndrome rules and diagnostic indicators for esophageal cancer after screening and sorting out the questionnaire items,convening experts to demonstrate.Results:62 valid questionnaires were collected,and the expert positive coefficient was 100%.The Kendall's coefficient of concordance W of the first and second rounds are 0.232 and 0.2334 respectively.In addition,the Kendall's coefficient of concordance W of the second round has been improved compared with the first round,suggesting that experts have a better degree of coordination on the importance of indicators.The common TCM syndromes of esophageal cancer are obtained:"liver-stomach disharmony,phlegm and qi obstruction syndrome","liver and spleen disorders,phlegm accumulating with stagnation syndrome","deficiency of liver and kidney yin,stubborn blood syndrome","deficiency of spleen and kidney yang,stubborn blood syndrome".Conclusion:The TCM syndrome indicators of esophageal cancer has been established.It provides a basis for the standardized research of TCM syndrome diagnosis of esophageal cancer,which is of positive significance for improving the level of clinical diagnosis and treatment.

基于Delphi-AHP的轻武器训练安全风险因素分析

轻武器是军队数量最多、使用频率最高,也是训练中出现安全事故较多的一类装备。为解决轻武器训练安全风险因素缺乏量化分析的问题,采用“Delphi构建指标-AHP确定权重-事故分析对比验证”的方法,首次构建了轻武器训练安全评价指标体系,系统分析风险因素。结果表明:基于Delphi-AHP确定的指标权重与事故分析结果较为一致,研究方法科学合理;轻武器训练风险性高、影响因素多,需重点考虑人员和管理因素,关注受训者技能水平、受训者安全意识、组织指挥、风险评估及隐患排查等因素,组训时需考虑不同种类轻武器风险因素差异。

Content Validity of a Self-Management Behavior Assessment Tool for Adult Post-Renal Transplant Recipients Using a Modified Delphi Method

Background: Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. Objective: This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. Methods: A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. Conclusions: The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.

Weighing and Prioritizing Noise Control Methods Using the Delphi Technique and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) in an Iranian Tire Manufacturing Factory

Undoubtedly,noise has become a major hazardous issue in today’s industrial world,with a lot of people suffering from exposure to excessive noise in their work environments.This study was conducted to weigh and prioritize noise control methods in an Iranian tire manufacturing complex in Iran.The Delphi method and the Technique for Order Preference by Similarity and an Ideal Solution(TOPSIS)were utilized for this purpose.This cross-sectional,descriptive study was conducted in the baking hall of an Iranian tire manufacturing factory in 2016.To weigh and prioritize noise control methods,Analytic Hierarchy Process(AHP)and TOPSIS were applied.In total,4 criteria and 8 alternatives were examined.An AHP and TOPSIS questionnaire was then designed to prioritize noise control methods in the light of the objectives,criteria,and alternatives.Then,the collected data were fed into Expert Choise.V.11 and Excel and data analysis was carried out using TOPSIS.The results of data analysis indicated that the inconsistency rate in all the cases was smaller than 10%,hence the consistency of the responses was verified.According to the TOPSIS results and experts’opinions about the criteria,implementation and maintenance cost(with a weight of 0.481)and method effectiveness and efficiency(with a weight of 0.046)had the highest and lowest priority respectively.Based on the weights TOPSIS,the appropriate methods for controlling noise in tire manufacturing are designing and manufacturing silencer,requiring people in charge to quickly fix the leaks and change baking press washers on time.

Ship System Maintenance Strategy Selection Based on DELPHI-AHP-TOPSIS Methodology

Maintenance decision problems generally involve multiple criteria which apparently are best addressed using Multi-Criteria Decision Making (MCDM) tools. This paper describes the use of a hybrid MCDM technique in prioritizing maintenance strategy for ship systems. The Hybrid MCDM technique combines Delphi method, AHP and TOPSIS methods. While the Delphi method and AHP are applied in screening of decision criteria and decision criteria weights determination respectively, the TOPSIS method is used in the ranking of alternative maintenance strategies. Five alternative maintenance strategies which include corrected maintenance, scheduled overhaul, scheduled replacement, continuous on-condition task and scheduled on-condition task are considered and the optimum maintenance strategy is selected based on twelve critical maintenance decision criteria. To demonstrate the suitability of the approach a case study of sea water pump of the central cooling system of a marine diesel engine is used.

基于Delphi法的社区人群轻度认知障碍疾病认知问卷编制研究

背景人口老龄化背景下,维护脑健康已成为健康中国建设的必然要求,开展社区人群认知障碍疾病认知研究具有重要意义,然而目前尚缺乏针对社区人群轻度认知障碍(MCI)疾病认知水平的调查工具。目的编制社区人群MCI疾病认知调查问卷,并检验其信效度,为促进认知障碍疾病管理提供依据。方法在文献研究、专题小组讨论基础上提出问卷设计的理论框架并初步编制问卷条目,于2021年4—5月采用Delphi法邀请13名相关领域专家进行2轮函询以对问卷条目进行评价,通过预调查对条目描述进行修订,于2021年10—12月通过问卷调查对条目进行难度指数分析、辨别度分析、相关性分析及信效度评价,进一步完善问卷。结果(1)专家函询:两轮函询专家积极程度分别为100.0%、84.6%,专家权威系数分别为0.858、0.845,两轮函询专家对各条目“重要性”评分均值分别为3.77~4.92、3.91~4.91,两轮评分变异系数分别为0.056~0.246、0.061~0.213,两轮函询肯德尔和谐系数分别为0.197、0.252(均P<0.001),两轮咨询分别收到29条、12条专家修改意见及建议。(2)问卷调查:共发放809份问卷,回收有效问卷797份,有效回收率98.52%。各条目难度指数为10%~90%,各条目辨别度指数大多高于20%,各条目得分及各维度得分均与问卷总得分呈正相关(P<0.05)。问卷Cronbach’sα系数为0.712,折半信度系数为0.764。模型检验结果KMO值=0.800(>0.6),Bartlett球形检验χ^(2)=3049.278(P<0.05),提示适合进行因子分析。探索性因子分析结果提示,因子累积方差贡献率为54.930%。最终问卷包括“对MCI基本知识的认识与理解”“个人就诊经历”“MCI诊疗期望”“就医决定与行为”4个维度,共20个条目。结论本研究基于Delphi法编制的社区人群MCI疾病认知调查问卷信效度较好,可作为调查社区人群MCI疾病认识水平的工具。

基于Delphi法的口服抗凝药物治疗患者知信行问卷研究

目的编制一套用于评价口服抗凝药物治疗患者知识、信念、行为的调查问卷。方法以知信行理论为指导,采用文献分析和访谈法设计口服抗凝药物治疗患者知信行初始问卷;采用Delphi法就初始问卷进行专家函询,并围绕专家建议修改问卷,形成最终问卷。结果向18名专家进行两轮函询,每轮函询均发放和回收18份问卷,专家积极系数为100%,专家权威系数为0.94。两轮函询中问卷所有维度、因子、条目的重要性均分均≥4分,变异系数均≤0.25,问卷整体及知识、信念、行为3个维度的肯德尔和谐系数为0.09~0.34(P均<0.05)。第一轮专家函询后修改4个条目,删除2个条目,新增5个条目;第二轮专家函询后修改10个条目。最终形成的问卷包含知识、信念、行为3个维度,17个问卷因子,40个条目。结论所编制的口服抗凝药物治疗患者知信行问卷的可靠性和科学性均较高,专家意见较一致,可用于评估口服抗凝药物治疗患者的知识、信念、行为现状。

Establishing nursing adverse events’reporting content of hospital:using the Delphi method

Objective:To develop nursing adverse events’reporting content of hospital.Methods:The study included two phases.The first phase was to develop the category and definition of nursing adverse events that need to be reported through an expert meeting.The second phase was to develop every nursing adverse event’s reporting content by using the Delphi method.In total,8 experts attended the meeting and 15 experts conducted two rounds of consultation letter.Results:Nursing adverse events that need to be reported of hospital include pressure sore,fall/falling from bed,unplanned extubation,medication error,and accident.Reporting content of these events in detail had also been obtained,which was helpful for cause analysis systematically.Conclusions:The reporting content of the nursing adverse event of hospital is established,and it is a basis for further study of the development of nursing adverse event reporting and feedback system.

基于Delphi+AHP的茶树种质资源管理评价指标体系构建

基于Delphi专家咨询法构建科学的茶树种质资源管理评价指标体系,为茶树种质资源的现代化管理提供评价工具。通过田野调研以及相关标准、管理办法等文献分析,初步拟定评价指标体系框架;以福建省为例,筛选18名专家进行2轮咨询,对专家特征、意见可靠性等进行统计分析,并采用AHP法计算权重。结果表明,2轮专家积极性系数均为100%,专家权威程度分别为0.809、0.847,最终确定4个一级指标、16个二级指标。茶树种质资源管理评价指标体系在专家库中达成了令人满意的共识,即符合中国茶树种质资源管理特色,体现交叉学科优势,适用于地方茶树种质资源管理评价工作。