Construction Of Traditional Chinese Medicine Nursing Quality Evaluation System For Diabetes Based On Three-Diamentional Quality Structure

Objective: To construct a practical and feasible diabetic TCM nursing quality evaluation system that reflects the characteristics of TCM nursing within the framework of three-dimensional quality structure theory,to provide a guiding basis and quantitative standard for the quality evaluation of diabetic TCM nursing,to make the quality management of diabetic TCM nursing more scientific,systematic and effective,to promote the homogeneous management between different departments and different hospitals,and to provide a reference for the continuous improvement of the quality of diabetic TCM nursing.Methods: This study is based on the three-dimensional quality structure theory.Through literature review,semi-structured interviews,and expert conferences,a draft of the quality evaluation system for TCM nursing in diabetes was developed.Experts were selected for 2 or 3 rounds of Delphi inquiry,and the system was modified and improved according to their opinions.The weight and combined weight of each indicator were determined using the Analytic Hierarchy Process,taking into account the importance scores given by experts after inquiry,and consistency was tested to form the quality evaluation system for TCM nursing in diabetes.Results:(1)Semi-structured interviews were conducted with four nursing managers,six clinical nurses,and four diabetes patients,and combined with the results of previous literature analysis to form a framework for the diabetes traditional Chinese medicine nursing quality evaluation system,which includes 3 primary indicators,22 secondary indicators,and 86 tertiary indicators.(2)Five experts participated in a conference to discuss the contents of the evaluation system,with one secondary indicator being deleted,one added,and four modified,and a total of 26 tertiary indicators being deleted,5 added,and 12 modified,resulting in a preliminary draft of the diabetes traditional Chinese medicine nursing quality evaluation system,which includes 3 primary indicators,22 secondary indicators,and 65 tertiary indicators.(3)Twenty-three experts completed two rounds of expert consultation,with a response rate of 95.83% and100.00% for the two rounds of questionnaires,respectively.The authority coefficients of the two rounds of consultations were both 0.874,indicating reliable results.The Kendall coordination coefficients for the two rounds of consultations were 0.118 and 0.194,respectively,and P<0.05,indicating good coordination among expert opinions.(4)The diabetes traditional Chinese medicine nursing quality evaluation system constructed in this study includes 3 primary indicators,23 secondary indicators,and 66 tertiary indicators.(5)The results of the Analytic Hierarchy Process(AHP)show that the weightings of the first-level indicators,structural quality,process quality,and results quality,are 0.2500,0.2500,and 0.5000,respectively,with results quality having the highest weighting.Among the second-level indicators,the combined weighting is highest for 1.6 nurse training in traditional Chinese medicine for diabetes(0.0602),2.1differentiation and treatment of diabetes in traditional Chinese medicine(0.0631),3.1patient satisfaction(0.0899),and 3.4 evaluation of the implementation effects of the traditional Chinese medicine nursing program for diabetes(0.0899).Among the third-level indicators,the combined weighting is highest for 1.3.2 responsibilities of nursing quality management personnel(0.0964),1.3.3 evaluation criteria for nursing quality management(0.0964),2.3.1 implementation of traditional Chinese nursing techniques for differentiation(0.1102),2.6.1 reporting and handling of unfavorable events(0.1102),and 3.2.1 job satisfaction of nursing staff(0.1322).Consistency checks show that the CR values are all less than 0.1,indicating that the weighting of each indicator in the diabetes traditional Chinese medicine nursing quality evaluation system is reasonable.Conclusion: The TCM nursing quality evaluation system of diabetes constructed in this study includes three primary indicators,23 secondary indicators,and 66 tertiary indicators.Weight values for each level indicator were scientifically determined,as well as the combined weight values.This provides a highly practical and operationally strong evaluation tool for comprehensively assessing the quality of TCM nursing for diabetes,thus contributing to the improvement of diabetes traditional Chinese medicine nursing quality and standardized management.