以患者为中心的居家护理服务质量评价指标的构建

目的 探讨构建以患者为中心的全面、科学、可靠、实用的居家护理服务质量评价指标,为完善居家护理服务模式提供参考。 方法 2021年2月—3月,基于文献检索和半结构访谈结果,拟订评价指标,形成专家咨询问卷,利用德尔菲技术,由19名护理或医学相关工作领域专家对指标（3个一级维度、9个二级维度及61个三级条目）进行咨询并确定各级指标权重。 结果 两轮专家咨询问卷的有效回收率均为100%,专家权威系数（Cr）为0.88,最后形成的居家护理服务质量评价指标包括3个一级维度、10个二级维度和46个三级条目;肯德尔和谐系数（W）一级维度由0.18增至0.32,二级维度由0.11增至0.30,三级指标由0.13增至0.20,均P<0.01。 结论 居家护理服务质量评价指标基本符合我国国情和以患者为中心的理念,具有较好的全面性、科学性、可靠性和实用性。

Construction of patient-centered evaluation index of home nursing service quality

Objective To explore the establishment of patient-centered comprehensive,scientific,reliable,and practical home care service quality evaluation indicators,and to provide a reference for the improvement of home care service models. Methods From February to March 2021,based on the results of evidence-based and semi-structured interviews,preliminary evaluation indicators were drawn up,and expert letter questionnaires were formed,through 2 rounds of Delphi method. 19 nursing or medical-related work fields experts consulted on these indicators（3 first-level dimensions,9 second-level dimensions,and 61 third-level items） and determined the weights of indicators at all levels. Results The effective recovery rate of the 2 rounds of expert letter consultations was 100%,and the expert authority coefficient（Cr） was 0.88. Finally,a home care service quality consisting of 3 first-level dimensions,10 second-level dimensions and 46 third-level items was formed. The first-level dimension Kendall’s W increased from 0.18 to 0.32;the second-level dimension increased from 0.11 to 0.30,and the third-level index increased from 0.13 to 0.20（all P<0.01）. Conclusion The evaluation index of home care service quality basically conforms to the basic national conditions of our country and conforms to the patient-centered concept,with strong comprehensiveness,scientificity,reliability and practicability.