| BackgroundHypertension is a common chronic disease in China,and it is an important hazard factor for cardiovascular and cerebrovascular diseases.At present,there are nearly 270 million hypertensive patients in our country and the task of prevention and treatment is arduous.There is an urgent need for better means to promote the prevention and treatment of hypertension.Previous studies have shown that community intervention is the most effective way to reduce the prevalence,disability and mortality of hypertension.However,there is a lack of unified problem assessment tools for community nursing staff in China before intervention,and the effect of community intervention needs to be improved.Therefore,exploring a simple and effective nursing evaluation tool is of great significance to help community nurses to find out the nursing problems of hypertension patients and to improve the effect of intervention.At the same time,it can provide some reference for the prevention and treatment of hypertension at the grass-roots level.Omaha Problem Classification System has been widely used in chronic disease assessment at home and abroad.Based on Omaha Problem Classification System,previous studies have developed a variety of nursing assessment tools for diseases,but there is still a lack of nursing assessment tools for hypertensive patients in our community.ObjectivesTaking the omaha problem classification system as the framework,this paper constructs the nursing problem assessment tool suitable form which is suitable for community hypertension patients in China,and probes into the evaluation effect of this evaluation tool on the nursing problem of the community hypertension patients in China.Methods1.5 doctors,11 nurses and 36 community patients with hypertension were selected by objective sampling method,and semi-structured interviews were conducted to extract the characteristics of nursing problems of community patients with hypertension.Based on the omaha problem classification system,and integrating with the characteristics of community hypertension patients' health problems,the indicators of community hypertension patients' nursing problem assessment table were preliminarily constructed.2.Delphi expert consultation method was used to further determine the indicators at all levels of community hypertensive patients nursing problem assessment tool.3.Test the validity of the letter and the reliability of the cronbach evaluation.50 community hypertensive patients were selected for the reliability of the pre-test evaluation form;and five experts were selected to measure the content validity of the test evaluation form.4.The nursing problems of 380 patients with hypertension in three community of Pingdingshan City were extracted and analyzed by using the community assessment tool of patients with hypertension.Results1.The nursing problem assessment tool of community hypertension patients contains four first-level indicators,29 second-level indicators and 114 third-level indicators.2.The response rates of two rounds of Delphi expert consultation were 100% and 96.88% respectively;the authoritative coefficients of two rounds of Delphi expert consultation were 0.797 and 0.806;the coordination coefficients of the first-level indicators were 0.322,the coordination coefficients of the second-level indicators were 0.271 and 0.312,and the coordination coefficients of the third-level indicators were 0.224 and 0.323,these marked tests have statistical significance(P < 0.001);Two rounds of Delphi expert Consultation level indicators evaluation coefficient of variation between 0.024~0.115,two levels of the coefficient of variation is 0.000~0.424,0.000~0.210;three level index coefficient of variation is 0.153~0.481,0.000~0.248 respectively.3.The Cronbach Alpha of the community hypertensive patients nursing problem assessment tool was 0.809.Content validity coefficient I-CVI at I-CVI was between 0.8-1.0,and S-CVI was 0.919.4.350 community patients with hypertension had 3614 nursing problems,with an average of 10 nursing problems per patient.Nursing problems of hypertension patients in community ranged from high to low: 1319(36.50%)in physiological field,1243(34.39%)in health-related behavior field,604(16.71%)in psychosocial field and 448(12.40%)in environmental field.The high incidence of nursing problems mainly included circulation,vision,pain,blood pressure monitoring,medication,sleep and rest,mental health and income.Conclusions1.The nursing problem assessment tool of community hypertension patients constructed has good reliability and validity,and can be used as an evaluation tool for community nurses to evaluate the nursing problems of community hypertensive patients.2.The assessment tool can help community nurses find out the existing and potential health problems of hypertensive patients in our community,provide direction for further intervention,and have certain guiding significance for improving the effect of primary prevention and treatment of hypertension in our country. |
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