Construction And Empirical Study Of Care Complexity Evaluation System For Chronic Heart Failure

Objective(1)Build a chronic heart failure Care Complexity evaluation system including patients,nurses,organization management,and equipment dimensions,and calculate the weight of each evaluation index.(2)Based on the above evaluation system,a patient-dimensional chronic heart failure patient care difficulty evaluation form is formed,and reliability and validity tests are conducted.(3)Use the difficulty evaluation table of chronic heart failure nursing for clinical empirical analysis,and analyze its influencing factors to provide reference for clinical precision nursing,nursing human resource allocation and performance evaluation.Methods1.Construction of evaluation system The literature review method and the semi-structured interview method were used to preliminarily formulate the evaluation indicators,the expert correspondence method was used to construct the chronic heart failure Care Complexity evaluation system,and the weight of each evaluation indicator was determined by the analytic hierarchy process to form the Care Complexity evaluation system.2.Reliability and validity test of the evaluation form The analytic hierarchy process was used again to determine the overall weight of the patient 's dimensional indicators,forming a Care Complexity evaluation table for patients with chronic heart failure,and 60 samples were selected for pre-experiment.The reliability was calculated using cronbach 's ? coefficient,and the content validity was calculated using expert scores.Sex factor method and principal component analysis method were used to check the structure validity.3.Clinical empirical research200 cases of chronic heart failure inpatients in the cardiovascular department of a top three hospital in Inner Mongolia were selected by the convenience sampling method,and the Care Complexity score was calculated using the Care Complexity evaluation table.Using t test or one-way ANOVA to analyze the differences of different genders,hospital admission methods,nursing level and other variables in patients with chronic heart failure.The Care Complexity score was graded using K-means clustering method.Results1.Construction of evaluation system(1)Index construction: a total of 20 experts in consultation were included,and the recovery rate of the two rounds of inquiries from experts was 100%.The expert authority coefficient is between 0.88-0.91 and the coordination coefficient is between 0.174-0.342.After 2 tests,it is concluded that P <0.05,which is statistically significant.From this,it is determined that the evaluation system of chronic heart failure Care Complexity includes patient dimensions and nurses Dimension,organization management dimension,equipment dimension,4 first-level indicators,15 second-level indicators and 46 third-level indicators.(2)Weight setting: The patient dimension(0.455)has the highest weight among the first-level indicators of the chronic heart failure Care Complexity evaluation system,followed by the nurses dimension(0.263),organization management dimension(0.141)and equipment dimension(0.141),and other indicators The weights are shown in the text and the appendix.A consistency test is performed on all judgment matrices: CR <0.1,which are all satisfactory consistency matrices with good logic.(3)Forming a Care Complexity evaluation table: Based on the above system,a patient Care Complexity evaluation table is obtained,which includes a total of 19 items including patient age,body mass index(BMI),heart failure grading,self-care ability,and social support.After pre-experiment,the cronbach's ? coefficient of the evaluation table is 0.905,the content validity ICVI is 0.85,SCVI is 1,and 6 factors are obtained through factor analysis,and the cumulative variance contribution rate is 44.946%,so the reliability of the evaluation table The degree is good,and the next clinical evidence can be carried out.2.Clinical evidence:The data of 200 patients with Care Complexity scores were normally distributed,with an average score of 1.42 ± 0.32.The K-means clustering method is used to divide the interval into three categories: 49 cases in the third category(0.653 ? 1.192),85 cases in the second category(1.204 ? 1.566),and 66 cases in the first category(1.580 ? 2.235).: The difficulty gradually increases from the third category to the first category,so the Care Complexity level of CHF patients is divided into: 3(<1.1 points)for low Care Complexity,and 2(1.1-1.6points)for medium Care Complexity,1 level(> 1.6 points)It is a high Care Complexity,and it is concluded that the Care Complexity of CHF patients is at a medium level.Through single factor analysis,it was found that there was no statistically significant difference in gender,marital status,occupation,and education level of CHF patients(P> 0.05).Nursing level,days of hospitalization,and hospital admission are factors that affect the difficulty of nursing.The difference is statistically significant(P <0.001).The higher the level of nursing,the more days of hospitalization.The higher the level of difficulty of nursing care for CHF patients admitted to the emergency department.Conclusion(1)This study successfully constructed a Care Complexity evaluation system for chronic heart failure,including 4 first-level indicators,15 second-level indicators and 46 third-level indicators.It is concluded that the difficulty of nursing to reduce CHF,treatment and nursing patients are the key,Improving the professional quality of nurses is the key,while reasonable organization and management and sufficient and perfect equipment are the prerequisites and prerequisites.The four complement each other and complement each other.(2)This study successfully constructed a 19-item chronic heart failure patient care difficulty evaluation table with good reliability and validity,which can objectively and comprehensively evaluate the Care Complexity of chronic heart failure patients.(3)According to clinical evidence: the difficulty of nursing for patients with chronic heart failure is at a medium level.In the nursing work,attention should be paid to patients with high Care Complexity: especially those who are admitted to the emergency department,have ahigh level of care,and have a long hospital stay.At the same time,different levels of nurses can be deployed according to the Care Complexity rating of patients with chronic heart failure,and the performance can be tilted to the nurses responsible for patients with high Care Complexity.