| Background:With the deepening of medical research,nursing,as an applied discipline,has its own theoretical knowledge system.In academic exchanges with other disciplines,nursing researchers and practitioners should use standardized nursing language.The classification of nursing outcomes(NOC)developed by the university of Iowa in the United States is the most widely used standardized nursing language in international nursing science,and has been applied and promoted in more than 50 countries around the world.The development of nursing in China is also inseparable from standardized nursing language."standardization" can not only help our nursing more standardized,but also promote our nursing more international.After the introduction of NOC in China,some researchers have applied it to patients with diabetes,stroke,chronic kidney disease and other diseases.The results show that NOC can effectively improve the quality of life of patients,improve the outcome of patient care,and has guiding significance for nursing practice.However,it is rarely used in myocardial infarction in China.As the incidence of myocardial infarction increases year by year,the incidence population is getting younger and younger,and complications often occur in clinical patients,resulting in poor prognosis.The purpose of this study was to improve the outcome of patient care.Through screening,revision and empirical study,this study provided a reliable outcome evaluation tool for hospitalized patients with myocardial infarction.Objective:This study intends to adopt the third edition of the nursing outcomes classification(NOC),combined with clinical nursing diagnosis of hospitalized patients with myocardialinfarction(MI),select the core of the main nursing outcome,through Delphi expert consultation method,the revision to meet China's national conditions and suitable for clinical nurses to assess myocardial infarction inpatients nursing assessment scale of the problem.The revised scale was used in the inpatients with myocardial infarction to test the reliability and validity of the scale.Through the evaluation of responsiveness and feasibility,standardized tools were provided for clinical nurses to accurately measure the nursing problems of patients,so as to systematically implement effective nursing measures.Methods:(1)Screening the outcome of core care for inpatients with myocardial infarction:literature analysis was used to determine the relevant nursing diagnosis;the most commonly used nursing diagnosis was selected by questionnaire survey.Link the diagnosis to the corresponding nursing outcome;clinical nursing staff according to Likert5 rating method to screen out the core nursing outcome.(2)Revision of the outcome of core care for inpatients with myocardial infarction:two rounds of consultation were conducted with the expert consultation method,and the final items were formed after deletion and modification according to the expert opinions to complete the revision of the outcome of core care.(3)Reliability and validity test and preliminary application of core nursing outcome in inpatients with myocardial infarction: the reliability and validity were analyzed by questionnaire survey.And the application of "risk control: cardiovascular health","self-care: daily life activities" outcome in patients with myocardial infarction in the investigation,measurement,admission of patients with outcome scores,analysis of clinical nursing outcome.Results:(1)primary 6 core nursing outcomes"Pain level","heart disease self-management","risk control: cardiovascular health","activity endurance","fear self-control","self-care: daily life activities".(2)revision of 6 core nursing outcomesAll the two rounds of expert questionnaires were collected,and the average degree of familiarity was 0.86,and the average coefficient of authority was 0.87.According to expert opinions and discussion by the research group,41 indicators were deleted,modified and merged,and the outcomes of "knowledge: disease care" were added.A total of 7 outcomes(including 88 items)were revised.(3)test of reliability and validityThe cronbach coefficient and sub-reliability of "pain degree","heart disease self-management","activity endurance","emotional self-control","knowledge: disease care","self-care: daily life activities" and "risk control: cardiovascular health" were 0.913,0.958,0.925,0.914,0.886,0.931 and 0.924,respectively.0.945,0.882,0.929,0.927,0.803,0.931,0.891.The content validity index(I-CVI)of each item in the 7 items of core nursing outcomes was between 0.82 and 1.00,and the content validity index(S-CVI)of the 7items of nursing outcomes scale was between 0.91 and 0.95.The reliability and validity of the core nursing outcomes were good.(4)2 clinical tests of nursing outcomesOutcome measures of "self-care: daily life activities" and "risk control: cardiovascular health" : the outcome scores of the patients on the day of discharge were higher than those on the day of admission,and the difference of d before and after admission was statistically significant(P < 0.001).Conclusion:Based on the third edition of nursing outcome classification(NOC),a total of 7 core nursing outcomes of inpatients with myocardial infarction were selected and revised in this study.The revised outcome indexes not only had good reliability and validity,but also met the requirements of localization,providing convenient and effective evaluation tools for clinical front-line staff.By putting a "care: daily life activity","risk control: cardiovascular health" two measures of ending the preliminary application of analysis in patients with myocardial infarction at admission and discharge of self-care ability and control ability,impacting on the health of the cardiovascular risk factors and give corresponding grading,comparing with the end of the level on admission,it is concluded that patients in hospital accepted during the period of holistic nursing and disease health education guidance is effective.It can be reflected from clinical practice that through the use of standardized nursing language and unified assessment tools,the nursing problems of patients can be captured conveniently,quickly and effectively,so as to implement targeted and personalized nursing measures.The measurement of nursing outcome can confirm whether patients have effect on the nursing service provided,so as to confirm the influence of nursing practice on patients' nursing outcome.The comprehensive evaluation of service quality can provide reference for the next step of nursing measures. |
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