基于德尔菲法初步编制门诊慢性病患者参与用药安全能力自评量表  

Preliminary Development of Self-assessment Scale for the Ability of Outpatients with Chronic Diseases to Participate in Medication Safety Based on the Delphi Method

作　　者：冯郑文 陈小垒 李卉 朱宸立 邵爽 杜娟 FENG Zhengwen;CHEN Xiaolei;LI Hui;ZHU Chenli;SHAO Shuang;DU Juan(School of General Practice and Continuing Education,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学全科医学与继续教育学院,北京市100069

出　　处：《中国全科医学》2024年第5期604-611,共8页Chinese General Practice

基　　金：北京市教育委员会科研计划项目(SZ202110025009)。

摘　　要：背景患者用药安全已成为世界关注的医疗卫生问题,患者对于促进自身用药安全发挥着重要作用。目的基于德尔菲法初步编制门诊慢性病患者参与用药安全能力自评量表,为评估及促进门诊慢性病患者参与用药安全能力提供客观标准。方法通过文献研究和半结构化访谈法拟定门诊慢性病患者参与用药安全能力量表初始条目。根据研究目的,采用德尔菲法对来自北京、上海、广东、天津、浙江、内蒙古的28名专家进行两轮函询,请专家对量表各维度的熟悉程度及判断依据进行评分,采用Likert 5级评分法对条目重要性及可行性进行评分。2021-09-30—10-12进行第一轮专家咨询,2021-11-05—15进行第二轮专家咨询,最后通过专家小组会议讨论确定最终条目。计算问卷回收率,以此反映专家积极性;采用权威系数衡量咨询结果的权威程度;采用变异系数及协调系数Kendall's W评价专家意见协调程度;重要性和可行性评分的算术均数≥3.5分且变异系数<0.25作为条目筛选的初步参考,同时结合专家意见,经研究小组成员和专家小组会议充分讨论后确定条目调整结果。结果两轮专家咨询均发出28份问卷,回收问卷28份,专家积极系数均为100%。两轮咨询专家权威系数为0.877。第二轮条目重要性和可行性的专家意见协调系数Kendall's W相较第一轮均有所提高。第一轮专家咨询结果显示,各条目重要性评分为3.964~4.964分,变异系数为0.038~0.211;可行性评分为3.964~4.821分,变异系数为0.081~0.265。第二轮专家咨询结果显示,各条目的重要性评分为4.321~5.000分,变异系数为0~0.168;可行性评分为4.036~4.893分,变异系数为0.064~0.186。两轮专家咨询及专家小组会议后最终确定了包括用药知识、用药信念、参与用药决策、用药自我管理4个维度、33个条目的门诊慢性病患者参与用药安全能力自评量表。结论本研究构建�Background Patient medication safety has become a global priority in healthcare,and patients play an important role in promoting their own medication safety.Objective To develop a Self-assessment Scale for the Ability of Outpatients with Chronic Diseases to Participate in Medication Safety based on the Delphi method and provide objective criteria for assessing and promoting their abilities to participate in medication safety.Methods A literature review and semi-structured interviews were used to formulate the initial entries of scale for the ability of outpatients with chronic diseases to participate in medication safety.According to the study objectives,28 experts from Beijing,Shanghai,Guangdong,Tianjin,Zhejiang,and Inner Mongolia participated in two rounds of correspondence using the Delphi method,and were asked to rate their familiarity and judgement basis of the dimensions,and the importance and feasibility of the items were rated using a five-point Likert scale.The first round of expert correspondence was conducted from 30 September to 12 October 2021,and the second round was conducted from 5 to 15 November 2021.Final items of the scale were determined through an expert panel discussion.The questionnaire recovery rate was calculated as a reflection of expert motivation;the degree of authority of the correspondence results was measured using the authority coefficient;the degree of coordination of expert opinions was evaluated using the coefficient of variation and the coordination coefficient Kendall's W.The arithmetic mean of importance and feasibility scores≥3.5 and coefficient of variation<0.25 were used as the initial reference for items selection,the adjustments of the items were decided after the thorough discussions among the members of research team and the expert panel combining with the opinions of experts.Results In both rounds of correspondence,28 questionnaires were sent out and 28 questionnaires were returned,with a positive coefficient of 100%and the expert authority coefficient of 0.877.The

关 键 词：慢性病 病人参与 用药安全 自我评价 德尔菲技术 

分 类 号：R36[医药卫生—病理学]