| Objective:To investigate the current status quo of continuous care for chronic obstructive pulmonary disease based on "Internet +" in tertiary general hospitals in Jiangsu Province;to construct a four-element continuous care model of "hospital-community-nursing home-family" for chronic obstructive pulmonary disease based on "Internet +".Methods:1.In this study,convenience sampling was used to select 35 tertiary general hospitals in Jiangsu Province,and then a self-designed questionnaire based on the implementation of Internet + COPD continuous care was used to find out how implementation had been carried out,and analyze the existing problems and influencing factors.2.Based on the review of previous research achievements and literature,the discharge needs assessment form of patients was formulated.Then,using the expert meeting method,15 respiratory experts were invited to design the continuing care needs assessment form of COPD based on "Internet +",for later implementation of "Internet +" chronic obstructive pulmonary disease discharged patients with continued care to evaluate the needs of patients.3.According to the problems in the implementation of Internet + chronic obstructive pulmonary disease continuous care in 35 tertiary general hospitals,the results of previous research and the continuous care needs of discharged patients with chronic obstructive pulmonary disease,referring to COPD related diagnosis and treatment guidelines,rehabilitation guidelines,and other materials,the research group constructed a four-element continuous care model framework and consultation questionnaire.The Delphi expert consultation method was adopted as 30 experts invited and went through two rounds of letter inquiries.As a result,a four-element continuous care mode of "hospital-community-nursing home-family" for COPD based on "Internet +" was constructed.Results:1.Among 35 tertiary general hospitals in Jiangsu province,31 hospitals have carried out continuous care for chronic obstructive pulmonary disease,which account for about 88.6%.Moreover,about 9.7% of the 31 hospitals have no cooperative units.At the same time,about45.2% of the hospitals unite families and community health service centers to carry out continuous care for COPD,and about 13% only unite families.18 out of 35 hospitals surveyed have carried out continuous care for COPD based on "Internet +",accounting for about 51.4%.Among the 18 hospitals,about 83.3% have inserted in the use of social software(We Chat,QQ),nursing service application(APP,We Chat applet)and self-developed hospital network platform.In addition,44.4% of the caring teams are made up of respiratory medical staff.It should be noted that about 83.3% of the hospitals have patients undergoing continuation care needs assessment before discharge,and about 83.3% of hospitals provide free "Internet+" continuing care for patients with chronic obstructive pulmonary disease.2.The "Internet +" chronic obstructive pulmonary disease discharged patients’ continuous care needs assessment form consists of three parts.The first part is the basic information of the patient,the second part is to assess the continuing care needs of discharged patients with chronic obstructive pulmonary disease,the third part is the patient’s or their caregivers’ willingness to continuous care.In the end,after discussion by the experts,a relatively unanimous opinion was reached.The first part of the evaluation form revised 8items,the second part revised 6 items,and the second part retained all the contents.3.Two rounds of expert letter inquiries have been conducted,and the effective rate of both rounds of questionnaires is 100%.The expert authority coefficient Cr value is 0.9,the value of the coefficient of variation of the two rounds of inquiry form is 0.037-0.185,0-0.124,and the Kendall’s coefficient of concordance significance test of the two rounds of inquiry is P<0.001,which is statistically significant.4.The four-element continuous care model of "hospital-community-nursing home-family" for chronic obstructive pulmonary disease based on "Internet +" includes 3first-level items,14 second-level items,and 32 third-level items.Conclusions:1.The tertiary general hospitals in Jiangsu Province are in good condition to carry out the continuous care of chronic obstructive pulmonary disease based on "Internet+",but there are still some problems.Initially,there are different standards for the composition of the continuous nursing team,which lead to the shortage of talents for continuous nursing.Apart from that,the guarantee system has not been established.Moreover,There is no united standard for nursing fees,and the online information platform still has flaws.2.A four-element continuous care model of "hospital-community-nursing home-family" for patients with chronic obstructive pulmonary disease based on the "Internet+" is refined from three aspects: the participating departments,the construction of information platform,and the quaternion linkage content of the nursing model.During the two rounds of expert letter inquiries,experts are highly motivated,therefore their opinions on the items are concentrated and coordinated,which shows the inquiry process is reliable. |
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