应用德尔菲法构建老年慢性病患者居家护理评估表

目的研制一份适合社区护士使用的老年慢性病患者居家护理评估表。方法以Gordon健康型态为理论评估框架,结合日常生活能力(activities of daily living,ADL)和工具性日常生活活动(instrumental activities of daily living,IADL)量表评估,初步构建老年慢性病患者居家护理评估表的框架和指标。采用目的性抽样的方法选取浙江省3所医院内从事社区护理、护理管理、健康教育及科研等方面工作的15名专家为咨询对象,利用德尔菲法确立评估表的最终结构和各项评估指标。运用专家意见的协调程度、积极系数、权威系数等指标对咨询的可靠性和代表性进行检验。结果专家的积极系数分别为100%和93.3%(>70%),权威系数分别为0.83和0.84(>0.7);两轮专家咨询后各项指标的变异系数为0.05～0.18(<0.3)。结论根据专家咨询的积极系数、权威系数、变异系数等结果证明,专家咨询的代表性和可信度高,基于德尔菲法构建的老年慢性病患者居家护理评估表可以全面地反映老年慢性病患者的健康状况。

Development of Home-based Nursing Assessment Scale Based on Delphi Method for the Elderly Patients with Chronic Illness

Objective To develop the home-based nursing assessment scale for the elderly patients with chronic illness. Methods Combined with activities of daily living （ADL） and instrumental activities of daily living （IADL） assessment, structure and items of the assessment scale were initially developed based on Gordon＇s health pattern. By purposive sampling, fifteen experts on community nursing, management, education and research were recruited and consulted. By Delphi method, scale structure and indicators were finally developed. Enthusiasm coefficient of experts, the authority coefficient of experts, the coeffi- cients of variation and the harmonization coefficient were used to examine the reliability and representation of expert consultation. Results Experts＇ positive coefficients were 100% and 93.3% （〉70%）, authority coefficients were 0.83 and 0.84（〉0.7） ,The variation coefficients of the fitness for all items ranged from 0.05 to 0.18（〈0.3） . Conclusion The home-based nursing assessment scale can more extensively reflect the health conditions of the elderly patients with chronic illness. Enthusiasm coefficients, authority coefficients and the variation coefficients showed that the expert consultations had good reliability and representation.