基于德尔菲法的精神卫生服务可及性评价指标体系研究  

Research on Evaluation Index System of Mental Health Service Accessibility based on Delphi Method

作　　者：何宇 杨小丽 HE Yu;YANG Xiao-li(School of Public Health and Management,Chongqing Medical University;Research Center of Medical and Social Development;Innovation Center of Social Risk Governance in Health,Chongqing 400016,China)

机构地区：[1]重庆医科大学公共卫生与管理学院医学与社会发展研究中心健康领域社会风险预测治理协同创新中心,重庆市400016

出　　处：《中国全科医学》2018年第3期322-329,共8页Chinese General Practice

基　　金：重庆市软科学计划项目(cstc2012cx-rkx A00044)--重庆市基本公共服务均等化实施策略研究

摘　　要：目的采用德尔菲法建立精神卫生服务可及性评价指标体系。方法 2016年6—12月,首先采用经验选择法邀请15名专家,组成专家咨询小组;然后在文献复习、小组讨论、专家访谈的基础上,根据德尔菲法的设计原则,确定专家咨询表;接着通过电子邮件的方式向15名专家分别发放专家咨询表,请专家对各项指标的重要性、熟悉程度、判断依据、合理性进行评分,同时对拟订的指标提出修改、删减或增加等意见;再者整理专家咨询结果,同时计算专家积极系数、专家权威程度、专家协调程度、指标筛选界值表;最后根据两轮专家意见及统计分析结果,最终形成精神卫生服务可及性评价指标体系,包括5个一级指标、10个二级指标、61个三级指标。分别采用Cronbach'sα系数、平均量表水平的内容效度指数(S-CVI/Ave)评价精神卫生服务可及性评价指标体系的内部一致性信度、内容效度。结果两轮咨询专家积极系数均为100.0%,专家权威程度分别为0.74、0.73,专家协调程度分别为0.23、0.30。两轮咨询专家对一、二级指标认可度高,并未提出修改、调整的建议,因此保持原有指标。根据三级指标满分比、变异系数均数及指标筛选界值表,同时参考专家意见,第一轮咨询增加了7个指标,第二轮咨询删减了14个条目,最终形成含有5个一级指标、10个二级指标、61个三级指标的精神卫生服务可及性评价指标体系。精神卫生服务可及性评价指标体系的Cronbach'sα系数、S-CVI/Ave分别为0.92、0.93。结论本研究基于德尔菲法构建的精神卫生服务可及性评价指标体系具有较好的信效度,具有一定的科学性和应用价值。Objective To establish an evaluation index system of mental health service accessibility based on Delphi method.Methods Fifteen experts were invited to form an expert advisory panel by empirical method from June to December 2016.An expert consultation table was made on the basis of literature review,group discussion and expert interviews according to design principles of Delphi method.The expert consultation table was delivered by E-mail and the significance and rationality of the indexes,the extent of familiarity and the basis for judgment were graded by these 15 experts with the opinions of how to revise,delete or increase the proposed indexes.The active coefficient,the degree of expert authority and the degree of expert coordination and critical value of indexes screening were calculated according to the results of the consultation.The evaluation index system of mental health service accessibility was finally established after two-round Delphi survey and statistical analysis,which included 5 indexes at the first level,10 indexes at the second level and 61 indexes at the third level.Then the internal consistency reliability and content validity of evaluation index system of mental health service accessibility were evaluated by Cronbach'sαcoefficient and scale-level content validity index/average(S-CVI/Ave).Results The active coefficients of two-round expert consultation were both 100.0%;the degree of expert authority for the first round was 0.74 and the second round was 0.73;and the degree of expert coordination was 0.23 and 0.30 respectively.Since all experts maintained a high degree of approval for indexes at the first and second level,the indexes were not revised.Seven indicators of the third level were added in the first round of expert consultation and 14 indicators of the third level were deleted in the second round of expert consultation according to the full mark ratio,coefficient of variation,critical value of index screening and experts'opinions.Cronbach'sαcoefficient of evaluation index system of m

关 键 词：精神卫生服务 卫生服务易得程度 德尔菲技术 

分 类 号：R197.1[医药卫生—卫生事业管理]