The Establishment And Application Of Evaluation Index System Of Health Problems In Patients With Chronic Heart Failure

ObjectiveThis study aims to establish the evaluation index system of health problems of patients with chronic heart failure in the theoretical framework of Omaha Classification System,which firstly is to determine the weight and combination weight of each index,secondly to test the reliability and validity of the evaluation index system and make application of the clinical trials and lastly to analyze both the current situation in health problems of patients with chronic heart failure and put forward relevant solutions.It is hoped to provide a theoretical basis for clinical nurses to propose targeted and effective interventions.Methods1.Adopt literature review,clinical data analysis,and semi-structured interviews to preliminarily formulate a item pool of health evaluation index system for patients with chronic heart failure.And then use Delphi method,combined with the inclusion criteria of indicators to revise each index and then form the evaluation index system of health problems of patients with chronic heart failure.Next employ Analytic Hierarchy Process and yaahp10.3 software to calculate the weight and combination weight of each index.2.Adopt convenience sampling to select patients with chronic heart failure treated in the Department of Cardiology of a Grade 3A Hospital in Qingdao as the research objects.And then use the Cronbach?s ? coefficient and half reliability coefficient to test the reliability of the evaluation system.Next use the content validity index to test the validity of the evaluation system,and the Knowledge-Behavior-Status(KBS)scoring guidelines of Omaha system were used for the clinical application of the evaluation index system.Finally,use SPSS 25.0 to analyze the data.Results1.The results of Delphi method of evaluation index system: In this study,a total of20 experts completed two rounds of correspondence questionnaires.The effective recovery rate of the questionnaires was 100%;The expert's judgment basis coefficient(Ca)is 0.950,the familiarity coefficient(Cs)is 0.800,and the authority coefficient(Cr)is0.875,which indicating a high degree of expert participation and authority.The coefficients of variation(CV)were 0.00?0.11,0.00?0.18 and 0.00?0.24 respectively and the Kendall'W were 0.387,0.359 and 0.238 for three levels of indicators,which indicated their opinions tended to be consistent.Finally,an index system for evaluating the health problems of patients with chronic heart failure was formed,which included 4 first-level indicators,27 second-level indicators and 126 third-level indicators.The weights of the four first-level indicators were in the following order: physiology(0.4094),health-related behavior(0.2895),social psychology(0.2047)and environment(0.0965).2.The results of reliability and validity test of evaluation index system: The Cronbach's ? coefficient and half reliability coefficient of the evaluation index system were 0.877 and 0.741 respectively and the item level content validity index(I-CVI)of the index system was 0.860.The consistent content validity index(S-CVI/UA)of the total index system was 0.810 and the average content validity index(S-CVI/Ave)of the total index system was 0.970.The results show that the evaluation system has high reliability and validity.3.The results of clinical application of evaluation index system: Through the clinical evaluation of 217 patients with chronic heart failure,the health problems with an prevalence of more than 60% were as follows: physical activity(100%),volume management(100%),circulation(98.16%),biochemical monitoring(98.16%),respiration(97.24%),immunity(93.55%),drug treatment(86.18%),disease awareness(84.33%),mental health(79.26%),sleep and rest patterns(71.43%),digestion-hydration(66.82%),a total of 11 items.Their KBS scores were all at a low level.Among them,the KBS score of immune health problems was the lowest,which were(1.17±0.52),(1.21±0.67),(1.32±0.99)respectively and the second was disease cognitive health problems,whose KBS scores were(1.88±1.25),(1.94±1.22),(2.00±1.51)respectively.ConclusionsThe evaluation index system of health problems in patients with chronic heart failure constructed in this study is comprehensive,scientific and reliable,and it also has a disease-specific characteristics.Through the test of reliability and validity and the clinical evaluation,it shows that the system has strong maneuverability,it can comprehensively summarize the existing or potential health problems of patients with chronic heart failure,and also provides a reference basis for further improving the quality of nursing.