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中国居家照护质量指标的发展

The development of quality indicators for home care in China.

作者信息

Tang Xianping, Chen Xuemei, Pang Yajuan, Zhou Lanshu

机构信息

School of Nursing, Second Military Medical University, No. 800 Xiangyin Road, Yangpu District, Shanghai 200433, China.

School of Nursing, Xuzhou Medical University, Xuzhou 221004, PR China.

出版信息

Int J Qual Health Care. 2018 Apr 1;30(3):208-218. doi: 10.1093/intqhc/mzx202.

Abstract

OBJECTIVES

To develop a comprehensive system of quality indicators for home care in China.

DESIGN

A modified Delphi technique and analytic hierarchy process.

PARTICIPANTS

Twenty experts were invited to participate in the Delphi expert consultation.

METHODS

Experts rated the perceived importance of 92 potential indicators through two rounds of e-mail surveys in November and December 2016. The analytic hierarchy process was used to determine the relative importance of the quality indicators identified through the Delphi expert consultation.

RESULTS

The average authoritative coefficient was 0.815 ± 0.0432 (range: 0.75-0.90). After two rounds of Delphi expert consultation, 77 quality indicators were identified as important in the Chinese home care setting. The mean importance ratings ranged from 4.35 to 4.95 on a 5-point scale, with variation coefficients ranging from 0.04 to 0.15. The percentage of experts giving the maximum possible score on each item ranged from 45% to 95%. In the second round, the Kendall's W coefficients ranged from 0.363 to 0.570. As for relative importance, the weights were 0.198-0.490, 0.029-0.047 and 0.037-0.66 for first-level, secondary-level and third-level quality indicators, respectively, with all consistency ratio values less than 0.1.

CONCLUSION

The absolute and relative importance of 77 indicators identified as potentially valid measures of the quality of Chinese home care was determined. This instrument is the first set of home care quality indicators developed specifically for mainland China, and it should be useful in evaluating and improving the quality of Chinese home care.

摘要

目的

建立一套全面的中国居家护理质量指标体系。

设计

采用改良德尔菲法和层次分析法。

参与者

邀请了20位专家参与德尔菲专家咨询。

方法

专家们通过2016年11月和12月的两轮电子邮件调查,对92个潜在指标的重要性进行评分。层次分析法用于确定通过德尔菲专家咨询确定的质量指标的相对重要性。

结果

平均权威系数为0.815±0.0432(范围:0.75 - 0.90)。经过两轮德尔菲专家咨询,确定了77个在中国居家护理环境中重要的质量指标。平均重要性评分在5分制中从4.35到4.95不等,变异系数从0.04到0.15不等。每个项目获得最高分的专家百分比从45%到95%不等。在第二轮中,肯德尔W系数在0.363到0.570之间。至于相对重要性,一级、二级和三级质量指标的权重分别为0.198 - 0.490、0.029 - 0.047和0.037 - 0.66,所有一致性比率值均小于0.1。

结论

确定了77个指标作为中国居家护理质量潜在有效衡量指标的绝对和相对重要性。该工具是专门为中国大陆开发的第一套居家护理质量指标,应有助于评估和提高中国居家护理的质量。

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