Construction And Reliability And Validity Test Of Pharmaceutical Care Model Of Nutritional Support Therapy

OBJECTIVE: The Delphi method was used to construct a set of standardized pharmaceutical care model of clinical nutrition therapy with good reliability and validity,Providing guidance to clinical nutrition support pharmacists.METHODS: Through literature review and combined with the practice of clinical pharmacists of parenteral nutrition pharmacists at home and abroad,the pharmaceutical care model of clinical nutrition therapy was preliminarily formed.The Delphi method was used to carry out two rounds of consultation on experts in the field of clinical nutrition,analyze the data obtained in each round,and preliminarily screen the entries according to the expert opinions,the mean value and coefficient of variation of item importance and feasibility score.After two rounds of expert enquiry,38 items were obtained,forming the initial pharmaceutical care model table of clinical nutrition therapy.Through the questionnaire star survey platform,227 questionnaires were collected,of which 216 were valid.In terms of statistics,spss22.0 was used to input data,and spss22.0 and AMOS23.0 were used to analyze the data.Descriptive statistical analysis was used to describe the general data of the research objects.The critical ratio method,item correlation with total score,internal consistency reliability test,commonality and factor load were used to analyze the items of the scale,and the items were screened again according to the item analysis results.Content validity,exploratory factor analysis and confirmatory factor analysis were used to evaluate the validity of the scale.Cronbach's coefficient and split-half reliability were used to evaluate the reliability of the scale.RESULTS: 1.The positive coefficients of two rounds of expert enquiry are 65% and 100% respectively.The degree of authority was 0.731 and 0.789 respectively.The Kendall coordination coefficients are 0.279 and 0.198 respectively.Finally,a pharmaceutical care model table of clinical nutrition therapy with 5 primary indicators,12 secondary indicators and 38 tertiary indicators was formed.2.In the project analysis,the CR value of each item in the critical ratio method was greater than 3.0 and had statistical significance.In the homogeneity test,items related to the total score,internal consistency reliability test,commonality and factor load index screening,all items meet the criteria,so there is no need to delete items.3.The pharmaceutical care mode table is divided into four subscales: nutritional status assessment subscale,formulation and implementation subscale of nutritional therapy program,review and comment subscale of medical advice,and subscale of medication monitoring plan.Validity: S-CVI of each subscale and total scale was 0.964,0.962,0.955,0.950 and 0.956,and I-CVI was between 0.864 and 1.00.The number of common factors extracted by exploratory factor analysis was basically consistent with the research hypothesis,and the cumulative variance contribution rate was all greater than 60%,among which the number of factors on the nutrition status assessment subscale was adjusted.4.The overall model fitness index of confirmatory factor analysis showed that the model fit well,and the internal structural fitness index showed that the average variance extracted(AVE)of each factor was greater than 0.5,the composite reliability(CR)was greater than 0.8,the path coefficient was greater than 0.7 and had statistical significance,the internal quality of the model was good.Reliability: Cronbach's coefficient of the subscale and the total scale was 0.940,0.968,0.916,0.967 and 0.982.The split-half reliability was 0.870,0.920,0.872,0.931 and 0.939.Finally,a pharmaceutical care model table of clinical nutrition therapy with 5 primary indicators,10 secondary indicators and 38 tertiary indicators was formed.Conclusion: After two rounds of expert enquiry,the pharmaceutical care model of clinical nutrition therapy was constructed,the construction process was scientific and reasonable,and its reliability and validity were tested.The scale had good reliability and validity,high reliability and stability,and all indexes reached the measurement standard.