| Objective:To deeply understand the attitudes and needs of patients with liver-qi stagnation cirrhosis on transitional care model of traditional Chinese medicine,to explore the views and suggestions of liver disease specialists on transitional care model of traditional Chinese medicine,to construct a transitional care model of traditional Chinese medicine for patients with liver-qi stagnation cirrhosis through Delphi expert consultation.In order to provide a reasonable and reliable basis for transitional care model of traditional Chinese medicine for liver-qi stagnation cirrhosis patients.Methods:1.Qualitative study:A total of 13 patients with liver-qi stagnation cirrhosis and 10 liver disease specialists were interviewed in depth using semi-structured guideline.The results were analyzed by Colaizzi phenomenon analysis.2.Delphi expert consultation method:Based on the Donabedian structure-process-result three-dimensional quality evaluation model,guided by the theory of“preventive treatment ”,combined with literature research,a transitional care model of traditional Chinese medicine for patients with liver-qi stagnation cirrhosis was initially formed.After two rounds of Delphi expert consultation,the final model was formed.Results:1.Through interviews with 13 patients with liver-qi stagnation cirrhosis,three themes were extracted:coping attitudes,complex and diverse continuing care needs,and diverse follow-up needs.Through interviews with 10 liver disease specialists,three themes were summarized:the understanding of transitional care of traditional Chinese medicine,difficulties and challenges in the implementation of transitional care of traditional Chinese medicine,suggestions for developing transitional care of traditional Chinese medicine.2.On the basis of previous research,a nursing model including7 first-level indicators,19 second-level indicators and 57third-level indicators were initially formed.After the first round of expert consultation,8 indicators were deleted,11 indicators were added and 13 indicators were revised.In the second round of expert consultation,6 indicators were added and 4 indicators were revised.The final nursing model included 6 first-level indicators,19 second-level indicators and 69 third-level indicators.The six first-level indicators and their weights were team building(0.195),facility allocation(0.173),quality control(0.095),evaluation of nursing goals(0.136),formulation of implementation plan(0.247),and evaluation content(0.253).3.A total of 22 experts completed two rounds of Delphi expert consultation.The effective recovery rate of the two rounds of expert consultation questionnaires were 88% and 100%respectively.The proportion of experts who provided opinions were63.6% and 22.7%.The expert authority coefficient was 0.866.The coordination coefficients of the first,second,and third levels of the second round of expert opinions were0.249,0.211,0.191(P<0.001),and the coefficient of variation was0.04～0.25.The mean value of all indexes in the second round of expert opinions was 3.64～4.95;the standard deviation was0.21～1.03;and the full mark ratio was 31.82～95.45.Conclusions:1.Through the semi-structured interview,we found that most patients had a high demand for transitional care of traditional Chinese medicine.Medical staff should start from the real experience of patients,make rational use of medical and health resources,and provide patients with personalized and comprehensive quality nursing services.2.The transitional care model of traditional Chinese medicine for patients with liver-qi stagnation cirrhosis constructed in this study was highly representative and authoritative;the research methods were scientific and rigorous,and the consultation results were scientific and reliable,which can provide a certain reference for clinical work. |
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