摘要
目的基于服务差距模型(service quality)构建医养结合型养老机构安宁疗护质量评价体系,为该类机构护理人员开展安宁疗护服务质量评价及改进提供参考。方法以SERVQUAL模型为理论框架,通过文献回顾和半结构访谈结果初步形成评价体系框架,采用德尔菲专家函询进行2轮专家函询,对指标进行筛选和修改,最终确定评价指标体系。结果2轮专家咨询均发放和回收问卷15份,有效回收率均为100.00%,说明专家积极性高;专家权威程度分别为0.78。2轮函询一级指标的Kendall协调系数W分别为:0.198和0.235(均P<0.05),且第2轮W值优于第1轮。第2轮各指标重要性评分为3.93~5.00分,变异系数0~0.20,权重0.01~0.28。最终构建的医养结合型养老机构安宁疗护质量评价体系包括5项一级指标、17项二级指标和64项三级指标。结论基于SERVQUAL模型构建的医养结合型养老机构安宁疗护质量评价体系具有科学性和可靠性,可为医养结合型养老机构开展安宁疗护服务质量评价提供参考,促进护理质量同质化,满足老年人及其家属的需求。
Objective To develop and evaluate a quality assessment system for palliative care nursing homes that integrate medical and elderly care services based on the SERVQUAL model,thereby providing references for assessment and improvement of the quality of palliative care.Methods Using SERVQUAL model,a preliminary evaluation of a quality assessment system for palliative care was developed through literature review and semi-structured interviews.Two rounds of expert consultation with Delphi method were conducted to refine and finalise the assessment system.Results The two rounds of expert consultation each involved 15 questionnaires,all effectively returned(100.00%response rate),reflecting strong expert engagement.The expert authority coefficients were 0.78.The Kendall’s W of primary irdicators were 0.198 in the first round to 0.235 in the second(P<0.05),showing improved consensus.The mean importance scores in the second consensus were 3.93-5.00,with coefficients of variation of 0-0.20,and weights of 0.01-0.28,respectively.The finallised assessment system comprised 5 primary indicators,17 secondary indicators and 64 tertiary indicators.Conclusion The SERVQUAL-based palliative care quality assessment system for integrated medical-elderly care nursing homes is scientifically rigorous and practically applicable.It offers a standardised tool for assessment and improvement of the quality of palliative care in nursing homes with integrated medical and elderly care services,promotes homogenisation of nursing quality and ultimately meets the needs of residents and their families.
作者
陈晨
糜迅
苏洁
陈新丽
张翠英
Chen Chen;Mi Xun;Su Jie;Chen Xinli;Zhang Cuiying(Department of Health Services,Nanjing Vocational College of Health,Nanjing 210000,Jiangsu Province,China;Department of Nursing Administration,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210000,Jiangsu Province,China;Health Services Department,Taikang Community(Suyuan),Taikang Healthcare,Nanjing 210000,Jiangsu Province,China.)
出处
《现代临床护理》
2025年第10期60-67,共8页
Modern Clinical Nursing
基金
国家中医药临床研究基地开放课题项目,项目编号为JD2023SZ08
南京市教育规划课题项目,项目编号为Oq4277
南京市科协软科学研究项目,项目编号为2024-66
江苏联合职业技术学院教育规划课题项目,项目编号为B/2024/7/014
南京卫生学校教育科研课题项目,项目编号为NJWX202305
南京中医药大学本科教育教学改革研究课题项目,项目编号为NZYJG2022148。
关键词
服务差距模型模型
医养结合
养老机构
安宁疗护
护理质量
德尔菲法
SERVQUAL model
integrated medical and elderly care
nursing home
palliative care
nursing quality
Delphi method
