| Objective To establish a well-developed nursing quality evaluation index system of postpartum visit that accords with the national condition of China. Determine the weights and combined weights of indicators at all levels of quality evaluation system, so that we can correctly treat the effect of each index in the general evaluation. The effect was analyzed through empirical research on the quality evaluation index system, which has the practicability and maneuverability of the evaluation tools for community postpartum family visit nursing quality evaluation.Methods A research team was built and relevant literatures were reviewed. Using “three-dimensional quality structure”mode as the theoretical framework, we established the rudiment of quality evaluation index system. Twenty-eight experts of relevant fields were enrolled and expert consultation was conducted using Delphi method. The experts were evaluated by positivity, authority, degree of opinion concentration and degree of opinion coordination. The reliability and validity of the evaluation index system are tested. Boundary value method was employed to conduct screening of quality evaluation indexes and analytic hierarchy process was employed to determine the weight of each index. Conducted an evidence-based survey on quality assessment of 18 Community Health Service Institutions, which were selected out of 3 major urban districts in Yinchuan City by stratified random sampling.Results1. Two rounds of expert consultation were conducted; the active coefficients were 100.0% and 96.4% respectively and the authority coefficients were 0.916 and 0.904.2. In the first expert consultation, there were 127 indexes. The arithmetic mean of importance score was 3.18~4.75, the ratio of full score was 0.04~0.75 and the standard deviation was 0.44~1.57. In the second round of expert consultation, there were 122 indexes. The arithmetic mean of importance score was 3.85~4.89, the ratio of full score was 0.11~0.89 and the standard deviation was 0.32~0.77.3. In the first round of expert consultation, the number of indexes with CV<0.2 was 107(84.3%). In the second round of expert consultation, the number of indexes with CV<0.2 was 122(100.0%). In the two round of expert consultation, the Kendall coordination coefficients were 0.173 and 0.186(P<0.01 for both).4. In the two round of expert consultation, the ranges of the Cronbach's ? among different indexes of each grade were from 0.752 to 0.986.5. In the result of confirmatory factor analysis, the index of ?2/df, RMSEA, NFI, NNFI, IFI, CFI, GFI, AGFI were 1.183, 0.058, 0.653, 0.829, 0.924, 0.896, 0.907, 0.803.6. In the finally evaluation index system constructed, the first-grade indexes were quality of structure, quality of process and quality of result and their weights were 0.2409, 0.5485 and 0.2106 respectively. There were 15 second-grade indexes and 103 third-grade indexes.7. The comprehensive quality grade of Community Health Service Institutions varied from 65.45 to 84.13 score. The grade span was 18.68 score, and the average quality grade of 18 Community Health Service Institutions was 79.43 score.Conclusion1. Using “three-dimensional quality structure” model as the theoretical framework, we established the nursing quality evaluation index system of community postpartum visit and the cover content was scientific and comprehensive.2. Experts had better representation, higher degree of concern for this study and familiarity with the content of the evaluation system.The opinions and suggestions from the experts were authoritative. The result of data analysis was reliable.3. Because of the combination of Delphi method and AHP, the weight setting results of nursing quality evaluation index system in community postpartum visit were more scientific, reliability and accuracy.4. Empirical results show that the nursing quality evaluation index system in community postpartum visit has certain operational and policy guidance. |
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