| Objective1.To understand the health status of elderly hypertension patients in the community,providing a basis for the construction of a comprehensive evaluation index system for elderly hypertension patients in community.2.Construct a more scientific and systematic comprehensive evaluation index system for elderly hypertension patients in the community based on Delphi method,and use the analytic hierarchy process to determine the weights and combined weights of indicators at all levels,and pass the reliability and validity test to evaluate the practicability and feasibility of the index system,which provide a basis to find personalized health issue,provide the main content of health management,and improve the management process of elderly hypertension patients in community.Method1.Questionnaire :using the health questionnaire for elderly hypertensive in community to survey 306 elderly hypertension patients with in 10 community health service institutions.2.Expert consultation method :based on nursing outcome classification、bio-psycho-social medical model and new health concept combined,combined with the results of the previous baseline survey,the comprehensive evaluation index system for elderly hypertensive patients in community was established.Using Delphi’s expert consultation method,after two rounds expert consultations,research team modify and improve the indicators at all levels according to professional opinion and screening criteria,finally building the comprehensive evaluation index system for elderly hypertension patients in community.3.Analytic hierarchy process :use the analytic hierarchy process to construct the weights and the combined weights of the comprehensive evaluation index system of elderly hypertensive patients in community.4.Statistical analysis :to test the reliability and validity of the index system based on the importance of the second round of expert consultation.Result1.306 elderly hypertensive patients in community have health problems in different ways.Principal component analysis was used to summarize 27 health problems into 8 common factors: physical symptoms,risk of falls,family support,life satisfaction,lifestyle,social support,stress resistance,and persistence in exercise,which provided the reference for the construction of the index system.2.This study has completed two rounds of expert consultations.Among them,the positive coefficients of 17 experts were 100.0%,and the experts who proposed amendments were 58.8% and 29.4%.The degree of Expert authority: the level of expert authority coefficient were 0.89,and the judgment coefficient level were 0.95 and 0.96,familiarity coefficient level are both 0.82;The arithmetic mean of the indicators of all levels in the first round of expert consultation and the second round of expert consultation were 3.53~5.00 and1.18~5.00 respectively.The degree of the expert coordination coefficient: in the first round of expert consultation and the second round of expert consultation,the indicators coefficient of variation <0.25 were 81.63% and 94.62%.The Kendall coordination coefficient in the first round of expert consultation and the second round of expert consultation were 0.233 and0.300(P <0.05).Finally,the comprehensive evaluation index system for elderly hypertension patients in community includes 5 first-level indicators,17 secondary indicators,and 63 tertiary indicators.3.The weights of the first-level indicators of the comprehensive evaluation index systemfor elderly hypertensive patients in community were: physical condition evaluation of elderly hypertensive patients in community(0.2112),mental and psychological evaluation of elderly hypertensive patients in community(0.3118),and knowledge 、 belief and behavioral evaluation of elderly hypertensive patients in community(0.3118),family status evaluation of elderly hypertensive patients in community(0.0642),community status evaluation of elderly hypertensive patients in community(0.1009).4.Reliability results show that the Cronbach’s α of the comprehensive evaluation index system for elderly hypertensive patients in community was 0.980,and the Cronbach’s αamong 85 indicators at various levels was 0.665~0.944.Using the content validity to illustrate validity,the content validity of items(I-CVI)was 0.82~1.00,and the content validity of index system(S-CVI)was 0.93.Conclusion1.At present,certain health problems exist in elderly hypertension patients in community in different aspects.It is highly recommend to put great emphasis on their physical symptoms,risk of falls,family support,life satisfaction,lifestyle habits,social support,stress resistance,and persistence in exercise condition.2.The comprehensive evaluation index system for elderly hypertensive patients in community has a more scientific and comprehensive coverage,and the weights are distributed reasonably.The weights of the indicators at all levels are scientific,reliable and accurate,and show good reliability and validity.It fits the status of community nursing development,which is conducive to the health management of elderly hypertensive patients in community.The 17 correspondence experts equip with good representation,authority and relatively high enthusiasm for this research.Meanwhile all the experts are familiar to research content,and their opinions are more concentrated,which guarantee the reliability of the results of the research results. |
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