| Objectives To construct a comprehensive and practical home safety risk assessment index system for ACS patients based on Delphi method,and to provide a basis for effectively reducing the home safety risk of ACS patients.Methods 1 To construct the evaluation index system of ACS patients' safety risk at home: by referring to relevant literature and theoretical analysis,the article pool of the evaluation index system of ACS patients' safety risk at home was constructed with the conceptual framework of "risk management theory" and "knowledge and practice theory".By adopting the Delphi method,19 medical experts from the department of cardiology of 12 grade a hospitals in 10 provinces and cities were invited to conduct two rounds of expert letter consultation.Experts were invited to assess the importance of each index and give advice.The results of the letter consultation were summarized to initially form an evaluation index system for the safety risk of ACS patients at home.2 Reliability and validity test: 594 ACS patients reexamined after discharge from the department of cardiology of a third-grade a hospital in shenyang were selected as research objects by convenience sampling method.The general situation questionnaire and the home safety risk assessment index scale of ACS patients were investigated to evaluate reliability and validity.The reliability was evaluated by internal consistency reliability,partial reliability and retest reliability,while the validity was evaluated by content validity and structure validity.Results 1 Based on "risk management theory" and "knowledge and practice theory" as the conceptual framework,the initial entry pool contains 4 dimensions and 66 index entries.(1)The effective recovery rates of the two rounds of expert letter consultation were 100% and 95%,respectively;The overall authority coefficients were 0.860 and 0.866,both of which were >0.8.The expert's coordination coefficients for all indicators were 0.229 and 0.356(P<0.001),respectively.(2)The mean score of the importance of each index in the second round of the consultation was 4.26?4.89(full mark of 5),and the coefficient of variation was 0.065?0.138,all <0.25.After two rounds of expert letter consultation,6 thirdlevel indicators were added,7 third-level indicators were modified and 8 third-level indicators were deleted(1 second-level indicator and 7 third-level indicators).(3)The calculation results of the weight values of each indicator show that the weight values of the four first-level indicators of preventing home safety risk knowledge,attitude,behavior and social psychology are 0.364,0.229,0.205 and 0.202,respectively.2(1)Project analysis: the correlation coefficient between the three-level index B1.2 and the total score did not reach the significance level(r=0.173,P<0.05),which was deleted,and the correlation coefficient between the remaining indicators and the total score of the evaluation form was between 0.309 and 0.714,all of which were >0.3.(2)Reliability test: the Cronbach's scale coefficient of the evaluation form is 0.940,and the Cronbach's alpha coefficient of the four dimensions is between 0.887 and 0.959.The overall fractional half-reliability was 0.963.The results of sensitivity analysis of each item show that the values of Cronbach's alpha coefficient of the index system are between 0.937 and 0.940.The total retest reliability was 0.928.(3)Validity test: S-CVI of the evaluation form is 0.975,I-CVI is 0.857?1.000.In the first exploratory factor analysis,a total of 10 common factors were extracted,and the contribution rate of the cumulative variance was 73.942%.The three indexes were summed according to dimensions,and exploratory factor analysis was conducted again to extract four common factors,with the cumulative contribution rate of 73.289%.Through the test of reliability,validity and acceptability,the evaluation index system of home safety risk for ACS patients was finally formed into 4 first-level indexes,10 second-level indexes and 53 third-level indexes.The average completion time was 10 minutes.Conclusions The final evaluation index system of home safety risk for ACS patients includes 4 first-level indexes,10 second-level indexes,and 53 third-level indexes,including knowledge,belief,behavior,and social psychology,which guard against home safety risk.Through preliminary verification,the evaluation system has good reliability and validity,short measurement time,strong reliability and practicability.Figure 2;Table 23;Reference 119... |
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