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中国防痨杂志 ›› 2024, Vol. 46 ›› Issue (2): 228-238.doi: 10.19982/j.issn.1000-6621.20230344

• 论著 • 上一篇    下一篇


高丹, 王玲华(), 黄金鹏, 郎雅珍   

  1. 杭州市红十字会医院结核病诊疗中心, 杭州 310003
  • 收稿日期:2023-09-25 出版日期:2024-02-10 发布日期:2024-01-30
  • 通信作者: 王玲华
  • 基金资助:

Construction of a tuberculosis patient follow-up program based on the “internet+” hospital-community-home linkage model

Gao Dan, Wang Linghua(), Huang Jinpeng, Lang Yazhen   

  1. Tuberculosis Treatment Center, Hangzhou Red Cross Hospital, Hangzhou 310003, China
  • Received:2023-09-25 Online:2024-02-10 Published:2024-01-30
  • Contact: Wang Linghua
  • Supported by:
    Hangzhou Medical and Health Technology Project(ZD20200071)

摘要: 目的: 构建基于“互联网+”医院-社区-家庭联动模式的结核病患者随访方案。方法: 基于“Donabedian结构-过程-结果”理论,采用文献分析、半结构访谈初步拟定“互联网+”医院-社区-家庭联动模式的结核病患者随访方案。2023年1—7月,通过德尔菲法对30名专家进行函询,对指标进行增减和修改,确定最终方案。以最后一轮专家函询重要性评分均数差值作为Saaty评价尺度,采用层次分析法计算各指标权重。结果: 最终完成3轮德尔菲专家咨询,3轮函询问卷的有效回收率分别为90.0%(27/30)、92.6%(25/27)和92.0%(23/25),提建议率分别为59.3%(16/27)、24.0%(6/25)和8.7%(2/23),专家权威系数Cr值分别为0.87、0.91、0.92,变异系数分别为0.082~0.326、0.060~0.114、0~0.123,肯德尔和谐系数由0.058增至0.122,χ2检验P值均<0.01。最终形成的随访方案包括一级指标3项(医院-社区-家庭联动模块、健康宣教模块、评价模块),二级指标19项,三级指标47项,并确定了各指标权重,一级指标权重分别为0.387、0.443、0.170,CR值均<0.1。结论: 基于Donabedian理论构建的“互联网+”医院-社区-家庭联动模式的结核病患者随访方案具有科学性、可靠性、实用性和较好的临床价值,各指标权重量性化,一致性程度高,增加了方案的逻辑性,为结核病患者随访提供了标准化流程。

关键词: 结核, 计算机通信网络, 随访研究, 德尔菲技术

Abstract: Objective: To construct a follow-up plan for tuberculosis (TB) patients based on the “internet+” hospital-community-family linkage model. Methods: Drawing upon the “Donabedian structure-process-result” theory, a follow-up plan for TB patients was developed within the framework of the “internet+” hospital-community-family linkage model through comprehensive literature analysis and semi-structured interviews. Using Delphi method, 30 experts were consulted from January to July in 2023. The indicators were then modified to determine the final plan. The mean difference of importance scores from the last round of expert correspondence was used for the Saaty evaluation scale, and the weight for each index was calculated with the Analytic Hierarchy Process. Results: Three rounds of Delphi expert consultation were completed with effectively retrieve rates of 90.0% (27/30), 92.6% (25/27) and 92.0% (23/25), respectively, and the recommendation rates were 59.3% (16/27), 24.0% (6/25) and 8.7% (2/23), respectively. The Cr values of expert authority coefficients were 0.87, 0.91 and 0.92, respectively, and the coefficients of variation were 0.082-0.326, 0.060-0.114, 0-0.123, respectively. The Kendall’s coefficient of concordance (W) increased from 0.058 to 0.122, and the Chi-square tests were all P<0.01. The final index system included 3 first-level indicators (hospital-community-family linkage module, health education module, evaluation module), 19 second-level indicators, 47 third-level indicators, and the weight of each index was determined. The weights of the three first-level indicators were 0.387, 0.443, 0.170, respectively, all CR<0.1. Conclusion: Drawing upon the Donabedian theory, the “internet+” hospital-community-family linkage model of TB patient follow-up program is feasible, reliable, practical and of good clinical value. The weight of each indicator is quantized and the consistency is high, which increases the logic of the program and provides a standardized process for the follow-up of TB patients.

Key words: Tuberculosis, Computer communication networks, Follow-up studies, Delphi technique