Abstract:

Objective To establish a nursing quality evaluation indicator system for patients with dysphagia after stroke,and to provide a basis for clinical nursing quality evaluation. Methods The research group established the first draft of dysphagia patients nursing quality evaluation based on the framework of the three-dimensional “structure-process-result” quality management model by literature review and brainstorming method. From March to May 2021, the first draft was revised by 2 rounds of expert consultations through Delphi technique. The final nursing quality evaluation system and indicators weight were analyzed by analytic hierarchy process. Results 2 rounds of consultations were completed by 21 experts. The questionnaire recovery rates were 100% and 95.23%;the expert authority coefficients were 0.958 and 0.964,respectively. Kendell harmony coefficients were 0.216 and 0.340 （P<0.001）. The mean value of importance of each indicator ranged from 3.9 to 5.0. The final nursing quality indicators of stroke dysphagia included 3 first-level indicators,9 second-level indicators （human resource allocation,equipment and facilities,management system,nursing evaluation,nursing practice,health education,follow-up management,nurse outcome,patient outcome） and 35 third-level indicators. Conclusion The nursing evaluation indicators system of stroke patients with dysphagia are scientific,reasonable,comprehensive and targeted,and it can provide references for nursing quality evaluation of stroke patients with dysphagia.

Key words: Stroke, Dysphagia, Delphi Technique, Nursing Quality Audit, Nursing Evaluation Research, Nursing Administration Research

摘要：

目的 构建脑卒中吞咽障碍患者护理质量评价指标,为临床脑卒中吞咽障碍患者护理质量评价提供依据。 方法 以“结构-过程-结果”三维质量管理模型为理论基础,通过文献回顾和头脑风暴法构建评价指标初稿,2021年3月—5月通过2轮德尔菲专家咨询对指标进行增、删及修改,使用层次分析法确定指标权重。 结果 共对21名专家进行2轮专家咨询,问卷回收率分别为100%和95.23%,专家权威系数分别为0.958、0.964,肯德尔和谐系数分别为0.216、0.340（P<0.001）,各级指标的重要性赋值均数为3.90~5.00分,最终构建的脑卒中吞咽障碍护理质量评价指标包括3个一级指标、9个二级指标和35个三级指标。 结论 该研究构建的脑卒中吞咽障碍患者护理评价指标科学、合理、全面且具有针对性,能够为脑卒中吞咽障碍患者的护理质量评价提供参考。

关键词: 脑卒中, 吞咽障碍, 德尔菲技术, 护理质量审核, 护理评价研究, 护理管理研究