基于结构-过程-结果模型日间化疗护理敏感质量指标体系的构建  

Construction of a sensitive quality indicator system for ambulatory chemotherapy nursing based on the structure-process-outcome model

作　　者：李硕[1] 金晓燕 高凤莉[1] LI Shuo;JIN Xiaoyan;GAO Fengli(Department of Nursing,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,P.R.China;Peking University Health Science Center-Macao Polytechnic University Nursing Academy,Macao Polytechnic University,Macao 999078,P.R.China)

机构地区：[1]清华大学附属北京清华长庚医院护理部,清华大学临床医学中心,北京102218 [2]澳门理工大学,北京大学医学部-澳门理工大学护理书院,中国澳门999078

出　　处：《华西医学》2025年第2期261-268,共8页West China Medical Journal

摘　　要：目的构建日间化疗护理敏感质量指标体系,为日间化疗护理质量评价及科学管理提供参考依据。方法基于Donabedian质量评价模型,通过文献研究初步构建针对日间化疗护理的敏感质量指标体系,使用德尔菲法进行两轮的专家咨询,确定最终的日间化疗护理敏感质量指标体系,并应用层次分析法计算各级指标的权重。结果两轮函询发放问卷15份,回收率均为100%,专家积极系数均为100%,权威系数分别为0.90、0.94,第二轮专家Kendall协调系数为0.573~0.769(P<0.01),最终构建的日间化疗护理敏感质量指标体系内容,包含3个一级指标、8个二级指标、27个三级指标。第二轮专家函询的整体Cronbachα系数为0.853,结构指标、过程指标、结果指标的Cronbachα系数分别为0.879、0.921、0.857。结论构建的日间化疗护理敏感质量指标体系具有较高的系统性、敏感性及科学性,权重分配合理,该指标体系可为客观评价和规范管理日间化疗护理质量提供参考依据。Objective To construct a sensitive indicator system for the quality of ambulatory chemotherapy nursing,and provide reference basis for the evaluation and scientific management of ambulatory chemotherapy nursing quality.Method Based on Donabedian’s three-dimensional quality structure model of“structure process result”,through literature review,a preliminary quality indicator system for ambulatory chemotherapy nursing was formulated.The Delphi method was used for two rounds of expert inquiry to determine the sensitive treatment indicator system for ambulatory chemotherapy nursing.The weight of the indicators was calculated using the hierarchical analysis method.Result Fifteen expert inquiry questionnaires were distributed through two rounds of inquiry,and the response rates of the two rounds of expert inquiry questionnaires were all 100%,with expert positivity coefficients of 100%and authority coefficients of 0.90 and 0.94,respectively.The second round of expert inquiry questionnaires Kendall’s coefficient of concordance were between 0.573 and 0.769(P<0.01).The final constructed quality sensitive indicator system for ambulatory chemotherapy nursing included 3 primary indicators,8 secondary indicators,and 27 tertiary indicators.The overall Cronbach’sαcoefficient for the second round of inquiry questionnaires was 0.853,while the Cronbach’sαcoefficients for structural indicators,process indicators,and outcome indicators were 0.879,0.921,and 0.857,respectively.Conclusions The sensitive indicator system for nursing quality in ambulatory chemotherapy wards constructed has high systematicity,sensitivity,and scientificity,and the weight distribution is reasonable.This indicator system can provide a reference basis for objective evaluation and standardized management of nursing quality in ambulatory chemotherapy.

关 键 词：日间化疗 护理敏感质量指标 德尔菲法 

分 类 号：R473.73[医药卫生—护理学]