Beijing Chao-yang Hospital, School of general practice and continuing education, Capital Medical University, Beijing, China.
Department of General Practice, The First Hospital of Tsinghua University, Beijing, China.
Fam Pract. 2023 Feb 9;40(1):105-112. doi: 10.1093/fampra/cmac072.
As one of the 3 strategic measures for disease prevention and control in the 21st century identified by WHO, patient education is the most effective measure to change people's behaviour and lifestyle. However, there are many problems with patient education in general practice in China. Because there is no suitable and uniform mode of patient education for the busy and crowded Chinese general practice. Therefore, it is necessary to establish an appropriate personalized patient education model.
There were 3 rounds of consultation of the Delphi method. Each round of consultation is adjusted, modified, or deleted based on the previous round according to the degree of concentration and coordination of expert opinions. Thus form the index system of personalized patient education model. Using Cronbach α to conduct an internal consistency test for the index system.
Twenty-three participants participated in the study. The effective recovery rate of consultation was 100%. In the third round of consultation, the variation importance coefficient was 0-0.25, the variation operability coefficient was 0.07-0.26. Kendall's W of importance and operability score was significant (Kendall's W = 0.186; P < 0.01). The chi-square test result of importance is (X2 = 232.744) and operability is (X2 = 246.156). The Cronbach α was 0.974. EFA (exploratory factor analysis) indicates the model has good construct validity.
The CAPDCA personalized patient education model was preliminarily constructed in this study. Specifically, 6 first-level indicators including collection (C), assessment (A), plan (P), do (D), check (C), aggrandizement (A), 24 second-level indicators, and 34 third-level indicators. That forms the cyclic personalized patient education paradigm which has reasonable structure and high feasibility.
患者教育作为世界卫生组织(WHO)确定的 21 世纪疾病防控 3 大战略措施之一,是改变人们行为和生活方式最有效的措施。然而,我国全科医疗中的患者教育存在诸多问题,由于没有适合中国繁忙、拥挤的全科医疗的患者教育的适宜且统一的模式,因此,有必要建立一种适宜的个性化患者教育模式。
采用德尔菲法进行 3 轮咨询,每轮咨询根据前一轮专家意见的集中程度和协调程度进行调整、修改或删除,从而形成个性化患者教育模式的指标体系。采用 Cronbach α 对指标体系进行内部一致性检验。
23 名专家参与研究,咨询的有效回收率为 100%。在第 3 轮咨询中,变异重要性系数为 00.25,变异可操作性系数为 0.070.26。重要性和可操作性评分的 Kendall's W 检验均有统计学意义(Kendall's W=0.186,P<0.01)。重要性的卡方检验结果为(X2=232.744),可操作性的卡方检验结果为(X2=246.156)。Cronbach α 为 0.974。EFA(探索性因子分析)表明该模型具有良好的结构效度。
本研究初步构建了 CAPDCA 个性化患者教育模式,包括收集(C)、评估(A)、计划(P)、执行(D)、检查(C)、强化(A)6 个一级指标、24 个二级指标和 34 个三级指标,形成了结构合理、可行性高的循环式个性化患者教育模式。