心力衰竭患者居家康复APP服务质量评价体系的构建  

Construction of a Service Quality Assessment Indicator System for Home-based Rehabilitation APP for Heart Failure Patients

作　　者：刘沈馨雨 高敏[2] 王洁[2] 鲍志鹏 于甜栖 汤志杰 孙姝怡 孙国珍[1,2] LIU Shenxinyu;GAO Min;WANG Jie;BAO Zhipeng;YU Tianxi;TANG Zhijie;SUN Shuyi;SUN Guozhen(School of Nursing,Nanjing Medical University,Nanjing 211166,China;Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学护理学院,江苏省南京市211166 [2]南京医科大学第一附属医院心血管内科,江苏省南京市210029

出　　处：《中国全科医学》2024年第30期3758-3762,3771,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(72074124);优势学科建设工程项目“护理学”(苏政办发〔2018〕87号)。

摘　　要：背景心力衰竭患者的心脏康复过程目前大多由医院转移至居家情境进行。移动健康应用程序帮助患者弥合了从医院向居家转移的支持缺口,促进居家康复进程,然而诸多质量问题接踵而至,其服务质量亟待“把关”。目的构建心力衰竭患者居家康复APP服务质量评价体系,为规范、提升我国移动健康APP服务质量提供参考。方法2022年7月—2023年1月基于文献分析、半结构式访谈拟定心力衰竭患者居家康复APP服务质量评价体系,对18名专家开展2轮函询。专家积极程度采用问卷回收率及意见提出率表示,专家权威程度采用权威系数表示,专家意见协调程度采用得分变异系数、肯德尔和谐系数表示。结合专家函询、层次分析法,确立最终的心力衰竭患者居家康复APP服务质量评价体系。结果2轮函询问卷有效回收率均为100%,专家权威系数为0.867,2轮函询肯德尔和谐系数分别为0.128~0.154和0.151~0.197(P<0.001)。最终构建的心力衰竭患者居家康复APP服务质量评价体系由软件属性、医学科学和行为科学特征三个维度组成,包含7项一级指标,24项二级指标和51项三级指标。结论构建的心力衰竭患者居家康复APP服务质量评价体系内容全面,具有科学性,对评价心脏康复APP服务质量及促进类似APP服务的良性发展具有一定借鉴意义。Background Nowadays,cardiac rehabilitation is mostly transferred from the hospital to a home environment.Mobile health applications assist patients in bridging the support gap from hospital to home environment,which encourages home-based recovery processes.Unfortunately,numerous quality difficulties accompany its promise,and the service quality of cardiac rehabilitation applications must be"confirmed"as soon as possible.Objective To develop a quality assessment indicator system for home-based rehabilitation APP services for heart failure patients,and to provide a model for standardizing and increasing the quality of mobile health APP.Methods This study was conducted from July 2022 to January 2023,using semi-structured interviews,literature review,the expert consultation method and analytic hierarchy process(AHP)to determine the content of indicator system and the weight for each index.Results 2 rounds of expert consultations resulted in the effective response rates of 100%,with the authority coefficients of 0.867,and the coordination coefficients of 0.128-0.154 and 0.151-0.197 respectively(P<0.001).As a result,an assessment indicator system for home-based rehabilitation APP services for heart failure patients was developed from three dimensions:software usability,medical professionalism,and behavioral science,with 7 primary indicators,24 secondary indicators,and 51 tertiary indicators.Conclusion The developed quality assessment indicator system for home-based rehabilitation APP services for heart failure patients is comprehensive and scientific,and can be useful for assessing and measuring the quality of heart rehabilitation APP services,as well as facilitating the benign development of similar APP services.

关 键 词：心力衰竭 心脏康复 家庭医疗保健服务 移动健康 服务质量评价 APP 

分 类 号：R541.62[医药卫生—心血管疾病]