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目的构建我国老年结核病患者心理健康、社会支持及自我健康管理干预效果评定的核心指标体系与量表,为老年结核病患者社会工作干预的评定提供可靠工具。方法通过文献查阅、小组讨论法等初步拟定备选条目池,再利用两轮德尔菲咨询定性与定量评价以筛选和完善指标形成初级的评定表。2016年4—5月在武汉市百步亭社区通过系统抽样的方法从社区卫生服务中心结核病登记管理系统中随机选出社区老年结核病患者32例进行预调查。通过预试验证实量表的结构、层次设计及内涵而形成最终老年结核病患者社会工作干预效果评定量表,包括5个一级指标,20个二级指标,94个三级指标。结果两轮专家咨询积极系数分别为73.3%和100.0%;德尔菲法评价后,最终专家意见集中程度条目获得性评分(Mj0)为(8.412±0.624),条目重要性评分(Mj)为(8.674±0.715),变异系数(CV)为(0.187±0.090),重要性评分满分比(Kj)为(0.542±0.160);权威系数(Cr)为(0.898±0.049);协调系数(W)=0.561,χ2=549.292,P<0.001,所有指标达到入选标准。共调查32例社区老年结核病患者,回收率为100.0%,合格率为100.0%。完成每份量表所花费时间为24~40 min,平均(32.6±7.2)min。只在态度和行为维度中微调外再无变动。结论利用德尔菲法所研制的老年结核病患者社会工作干预效果评定量表专家积极性、权威性及支持度均较高,专家意见集中程度和协调性均达到了科学要求,所得结果可靠。
Objective To establish a core index system and scale for assessing the effect of mental health, social support and self-management intervention on senile patients with tuberculosis in our country and provide a reliable tool for the evaluation of social work intervention in senile patients with tuberculosis. Methods Through the literature review, group discussion and other preliminary preparation of alternative entries pool, and then use two rounds of Delphi consulting qualitative and quantitative evaluation to filter and improve the indicators to form a preliminary rating form. From April to May in 2016, Baibuting community in Wuhan City selected 32 community-aged elderly TB patients randomly from the Community Health Service Center Tuberculosis Registration Management System by systematic sampling method. Through the preliminary test to confirm the structure, level design and connotation of the scale to form the final elderly TB patient social work intervention evaluation scale, including five first-level indicators, 20 second-level indicators, 94 third-level indicators. Results The coefficient of positive consultation of two rounds of expert consultation was 73.3% and 100.0% respectively. After the Delphi method was evaluated, the final score of expert opinion concentration (Mj0) was (8.412 ± 0.624) and the item importance score was (8.674 ± 0.715), the coefficient of variation (CV) was (0.187 ± 0.090), the score of fullness score was (0.542 ± 0.160), the coefficient of authority (Cr) was (0.898 ± 0.049), the coefficient of coordination , χ2 = 549.292, P <0.001, all indicators reached the inclusion criteria. A total of 32 elderly patients with tuberculosis were surveyed, with a recovery rate of 100.0% and a pass rate of 100.0%. The time it took to complete each scale was 24-40 min with an average of (32.6 ± 7.2) min. Only in the attitude and behavior of fine-tuning outside no change. Conclusion The positive, authoritative and supportive experts in evaluating the effect of social work intervention in elder patients with tuberculosis developed by the Delphi method all have high levels of scientific advice and concentration. The results obtained are reliable.