| Background & Objective:The morbidity and mortality of coronary heart disease (CHD)have been rising continually. CHD becomes the killer which is a threat to people's health and lives in China. Health education is a social and education activity which is planned, organized and systematic. It can improve the knowledge level of patients with CHD, change their attirudes and beliefs, alter their delinquenent conduct, and then amend their health condition and improve the quality of life. Outcome assessment is evaluating the effectiveness of health education. Establishing outcome assessment standard system of health education can ensure implement the outcome assessment of health education effectively, and can motivate health education to obtain the best effect, thereby improve patients' satisfaction significantly. However,the outcome assessment indicators for health education of CHD at home and abroad are lack of standardization, systematization. Index system has not been formed. When the researchers implement evaluation, they choose different indicators according to their research purpose respectively. Using complex scales not only leads to different standards between hospitals, but also reduces the efficiency of outcome assessment. So, this study establishes the outcome assessment index system for health education of CHD, which is formed by documentary analysis, so as to improve the effectiveness of health education,questionnaire survey, Delphi method, and analytic hierarchy process. The index system is order to provide a unified reference standard for comprehensive outcome assessment of health education of CHD, and then guide nurses to carry out targeted health education further, so as to improve the effectiveness of health education.Procedures & Methods:Though documentary analysising, theoretical basis was confirmed, which is Knowledge,Attitude,Belief,Practice(KABP) model of health education. Then, after the KABP model combination with guidelines for secondary prevention for patients with CHD and nursing outcomes in CHD, we established 6 first-dimensions. A qualitative study was conducted to explore the perspectives of 12 patients with CHD,23 cardiology nurses. After mergering similar indicators, we got 34 second-dimensions.In addition,we refered to other indicators,then established the frame of index system, which included 6 first-dimensions and 54 second-dimensions. Then, a total of 161 cardiology nurses whose work-life is greater or equals to 5 years were surveyed by using questionnaire, which was estalbished based on the frame of index system. After analysing datas,7 indicators were deleted. Two rounds of expert enquiry were implemented, then according to 18 experts'opinions, we eatalished the primary index system which included 6 first-dimensions and 45 second-dimensions. A total of 320 patients with CHD in four three grade A hospitals who were extracted by convenient sampling method were surveyed. Project analysis, exploratory factor analysis and reliability and validity tests were applied to select items.Results & Conclusions:The system is consisted of 8 first-dimensions and 35 second-dimensions. The first-dimensions include health kowledge, health belief, basic health behavior, rid of bad habits, alarming behaviors,satisfaction degree of health education, quality of life and physical signs. The Cronbach's a of the total system was 0.832, and the a of subscales were from 0.629 to 0.882. The test-retest reliability of the total system was 0.966, and the test-retest reliability of subscales were from 0.848 to 0.942. The S-CVI/UA of indicators was 0.91, and the S-CVI/Ave of system was 0.99. Factor analysis supported the eight-factor structure of the system, which could explain 65.61% of the total variance and the factor loading of each index were from 0.430 to 0.938. The results demonstrate that the system is reliable and valid,and can provide a unified reference standard for outcome assessment of health education of CHD. |
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