Research On The Establishment Of Pre-diabetes Health Education Quality Evaluation System Based On The Three-dimensional Quality Structure Theory

ObjectiveTo study the evaluation indicators of pre-diabetes health education,and plan to build a set of scientific and feasible index system to provide operable and practical evaluation tools and reference standards for the quality evaluation of pre-diabetes health education.MethodsBased on the literature review and semi-structured interviews,the preliminary entry of the prediabetes health education quality evaluation index system was formed based on the Donabedian "structure-process-result" three-dimensional quality theory as the framework.The Delphi method was used to conduct 2 rounds of consultation with 28 diabetes experts in 5 provinces,including Shandong,Beijing,Liaoning,and Sichuan.The experts were asked to rate the index content and propose amendments.Calculate the authoritative coefficient,positive coefficient and coordination coefficient of experts,based on which to comprehensively analyze the authoritativeness,enthusiasm,opinion concentration and coordination of experts;calculate the Kronbach coefficient and confirmatory factor,and evaluate the comprehensive inspection indicators based on this Reliability and validity of the structure of the system;the "entropy value method" is used to calculate the information entropy of the indicators at all levels,and the index weights are determined according to the overall impact of the relative change of the indicators at all levels on the evaluation system.Results1.According to the selection criteria,a total of 28 experts completed the two rounds of consultation in this study,the positive coefficients were 93.33% and 100% in turn;the authoritative coefficients were 0.791 and 0.907,both> 0.7.2.Among the 87 indicators of the first round of consultation results,the average value of importance is between 1.807 and 4.807,the full score ratio is 0.14 to 0.79,and the standard deviation is 0.401 to 1.230;among the 89 indicators of the second round of consultation results The average value of importance assignment is between 3.57 and 4.96,the full score ratio is between 0.17 and 0.87,and the standard deviation is between 0.196 and 0.852.From this,we can see that the opinions of experts are highly concentrated.3.The results of the first round of consultation showed that there were 72 indicators with a coefficient of variation <0.3,accounting for 82.76%;87 indicators with a coefficient of variation <0.3,accounting for 97.75% in the second round;It was 0.288,0.253,Chi-square test P <0.001,with statistical significance.4.The reliability analysis results of the indicator system show that the Cronbach'a coefficients of the first,second,and third indicators are 0.825,0.878,and 0.955,respectively,indicating that the questionnaire reliability is good.5.Validation factor results show: chi-square test of goodness of fit,root mean square error of approximation,conventional fit index,incremental fit index,relative fit index,comparative fit index,root mean square difference,good fit The degree index and the adjusted goodness-of-fit index are 1.097,0.062,0.639,0.952,0.931,0.943,0.023,0.726,and 0.603,indicating that the first-and second-level index models in the evaluation system have a good fit.6.The analysis results of entropy method show that the weight values of the first-level indicators are: structural quality(0.155),process quality(0.672),and result quality(0.173).The weights of the second-level indicators ranked in the top three are "patients with prediabetes cognition","nurse knowledge and technology","patient-related health behavior changes".The top three weights in the three-level indicators are "effective weight control","whether the patient's fasting and blood glucose levels at 2 hours after a meal meet the standard",and "health education staff title".7.The deletion and modification of indicators.According to the opinions and suggestions of experts,apply the boundary value method to delete "nurse gender","nurse physical quality","nurse psychological quality","nurse's awareness rate of health education plan","education center disinfection sterilization pass rate",6 secondary indicators such as "follow-up time",modify 2 secondary indicators such as "weight management" and "changes in patient-related health behaviors";add "set weight control goals: overweight/obesity: 3-6 months to reduce 5% to 10% of body weight",patients "can effectively control weight","can understand the knowledge of general monitoring indicators such as weight and blood pressure","can have a positive attitude","can master scientific disease knowledge","can Make 7 self-tests and records of blood glucose,and "can regularly check according to doctor's instructions" and other three level indicators.8.Finally,a pre-diabetes health education evaluation indicator system was constructed and the weights of indicators at all levels were determined,including 3 first-level indicators,14 second-level indicators and 62 third-level indicators.ConclusionsThis study uses the Donabedian "structure-process-result" three-dimensional quality structure model as the theoretical framework to build a pre-diabetes health education quality evaluation system,covering scientific and comprehensive content;consulting experts have a high degree of interest in this study,are familiar with diabetes and can Provide more reasonable and comprehensive opinions and suggestions in the field,with good representativeness and authority;combining the Delphi method and entropy method to make the weighting results of indicators at all levels in the evaluation system more scientific,accurate and Reliability;the credibility and validity of the evaluation show that the expert opinions of the index system are concentrated,and the results are highly credible,which can provide a quantitative basis for the quality evaluation of pre-diabetes health education.