Please wait a minute...
文章检索
预防医学  2019, Vol. 31 Issue (3): 255-259    DOI: 10.19485/j.cnki.issn2096-5087.2019.03.009
  论著 本期目录 | 过刊浏览 | 高级检索 |
应用德尔菲法构建全科适宜技术目录
苏琳, 张佳, 朱文华, 戴红蕾
浙江大学医学院附属邵逸夫医院全科医学科,浙江 杭州 310016
Construction of an appropriate technology catalogue for general practice based on Delphi method
SU Lin, ZHANG Jia, ZHU Wen-hua, DAI Hong-lei
Department of General Practice,Sir Run Run Shaw Hospital,Hangzhou,Zhejiang 310016,China
全文: PDF(601 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 应用德尔菲法构建全科适宜技术目录,为全科适宜技术推广和全科医生临床技能培训提供参考。方法 根据浙江大学医学院附属邵逸夫医院和杭州市2家社区卫生服务中心全科门诊前20位疾病的诊断资料及国内外全科医学相关文献,拟定目录框架,邀请14名来自三甲医院和社区医院的全科医生进行2轮专家咨询,评价专家积极系数、专家权威程度和专家意见协调程度,确定最终的全科适宜技术目录。结果 14名专家中本科学历9人、硕士及以上5人;副主任或主任医师12人,主治医师2人;从事全科医疗工作平均年限17.21年。2轮咨询专家积极系数均为100.00%,专家权威程度平均为0.891。第一轮咨询后,6个Ⅰ级指标的重要性和可行性W分别为0.170和 0.244,56个Ⅱ级指标的重要性和可行性W分别为0.236和 0.250(均P<0.05),其中6个Ⅱ级指标的重要性或可行性CV≥0.25,予以剔除。第二轮咨询后,6个Ⅰ级指标的重要性和可行性W分别为0.245和0.247(均P<0.05);50个Ⅱ级指标的重要性和可行性W分别为0.355和0.370,CV均<0.25。最终构建了基本诊疗技能、急救技能、症状学诊疗技能、慢性病管理技能、常见病诊疗技能和常用操作技能6个Ⅰ级指标和50个Ⅱ级指标组成的全科适宜技术目录。结论 本研究专家的积极程度和权威程度较高,专家意见协调性较好,结果可靠,制定的全科适宜技术目录可推广应用。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
苏琳
张佳
朱文华
戴红蕾
关键词 全科医学适宜技术目录德尔菲法    
AbstractObjective To construct an appropriate technology catalogue for general practice based on Delphi method,and to provide reference for promoting appropriate techniques and training general practitioners.Methods The catalogue was briefly constructed based on literature reviews and the data of the top twenty diseases diagnosed in out-patient department of Sir Run Run Shaw Hospital and two community health service centers in Hangzhou. Two-round Delphi consultation was conducted by fourteen general practitioners coming from upper first-class hospitals and community hospitals. The final catalogue was established according to evaluation of the degree of involvement,authority coefficient and Kendall's W values of the fourteen specialists.Results Of the fourteen specialists,nine had bachelor's degrees and five had master's degrees or above;twelve were deputy chief physicians or chief physicians and two were physicians. They were engaged in general practice for 17.21 years in average. The positive coefficients of the two rounds of consultations were both 100.00%. The authority coefficient of the specialists was 0.891. After the first round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.170 and 0.244,and the ones of 56 second-class indicators were 0.236 and 0.250(all P<0.05). Six of second-class indicators were excluded because their coefficent of variation(CV)for importance and feasibility were more than 0.25. After the second round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.245 and 0.247,and the ones of 50 second-class indicators were 0.355 and 0.370(all P<0.05). The CV for each indicator was less than 0.25. Finally,an instructional catalogue was defined,consisting of 6 first-class indicators(basic diagnosis and treatment skills,first aid skills,symptomatic diagnosis and treatment skills,chronic disease management skills,common disease diagnosis and treatment skills,and common manipulative skills)and 50 second-class indicators.Conclusion The degrees of involvement,authority and consistency of the specialists were relatively high. The catalogue of appropriate technology for general practitice had good reliability and feasibility,which was worthy of promotion and application.
Key wordsGeneral medicine    Appropriate technology    Catalogue    Delphi method
收稿日期: 2018-10-08      出版日期: 2019-03-04
ZTFLH:  R197.1  
通信作者: 戴红蕾,E-mail:3202016@zju.edu.cn   
作者简介: 苏琳,硕士,医师,主要从事未分化疾病、常见病诊治和慢性病管理工作
引用本文:   
苏琳, 张佳, 朱文华, 戴红蕾. 应用德尔菲法构建全科适宜技术目录[J]. 预防医学, 2019, 31(3): 255-259.
SU Lin, ZHANG Jia, ZHU Wen-hua, DAI Hong-lei. Construction of an appropriate technology catalogue for general practice based on Delphi method. Preventive Medicine, 2019, 31(3): 255-259.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2019.03.009      或      http://www.zjyfyxzz.com/CN/Y2019/V31/I3/255
[1] 王岚,杜亚平. 中英全科医疗服务模式的比较与探讨[J]. 全科医学临床与教育,2011,9(3):241-243,245.
[2] 房鑫,郝艳华,吴群红,等. 我国全科医生现状成因分析与对策探讨[J]. 中华全科医学,2016,14(7):1199-1201,1213.
[3] 郭雪,刘琴,于晓羽,等. 中国适宜卫生技术评估研究的系统评价[J]. 中国循证医学杂志,2012,12(12):1407-1415.
[4] 王春枝,斯琴. 德尔菲法中的数据统计处理方法及其应用研究[J]. 内蒙古财经学院学报(综合版),2011,9(4):92-96.
[5] 张立威,黄婉霞,徐庆锋,等. 基于德尔菲法的全科医生转岗培训效果评估指标体系构建研究[J]. 中国全科医学,2013,16(25):2271-2273.
[6] 丁晋飞,谈立峰,汤在祥,等. 德尔菲法及其在公共卫生领域的应用和展望[J]. 环境与职业医学,2012,29(11):727-730.
[7] 薛敏,马莎,刘薇,等. 基于德尔菲法的卫生监督效能评价指标体系权重研究——以上海卫生监督机构为例[J]. 中国卫生监督杂志,2014,21(3):212-218.
[8] 付咏梅. 社区访视护理现状分析及访视护理质量评价指标的构建研究[J]. 中国社区医师,2013,29(20):90-94.
[9] 李和伟,李炜良,袁纲. 德尔菲法在中国社区卫生服务领域内的应用[J]. 中国公共卫生管理,2015,31(1):15-17.
[10] 韦余东,张人杰,张新卫,等. 应用德尔菲法构建疾控机构应急能力评价指标体系[J]. 浙江预防医学,2016,28(1):32-36.
[11] 赵玉遂,许燕,吴青青,等. 应用德尔菲法构建网络健康信息质量评价指标体系[J]. 预防医学,2018,30(2):121-124.
[12] 周仲华,黄文娟,陈仕银,等. 三级综合医院全科医疗门诊患者就诊原因及诊断情况研究[J]. 中国全科医学,2012,15(23):2652-2655.
[13] 王慧,江孙芳,汪志良,等. 上海某社区卫生服务中心2010—2014年疾病谱分析[J]. 中国初级卫生保健,2016,30(2):32-34.
[14] 王荣英,李峰,支晓,等. 基于门诊就诊疾病谱分析的综合医院全科医疗科在分级诊疗中的定位与发展探讨[J]. 中国全科医学,2016,19(28):3417-3421.
[15] MURTAGH J.John Murtagh’s general practice[M]. New South Wales:McGraw-Hill Australia,2011:2.
[16] 艾尔巴比. 社会研究方法[M]. 李银河,译. 成都:四川人民出版社,1987.
[17] 曾光. 现代流行病学方法与应用[M]. 北京:北京医科大学、中国协和医科大学联合出版社,1994:258-259.
[18] 王高玲,别如娥.基于Delphi法的居民健康素养评价指标体系的研究[J]. 中国卫生统计,2013,30(5):676-679.
[19] 韩鹏,陈校云,张铁山,等. 基于德尔菲法的医院门诊及住院医学人文关怀指标体系研究[J]. 中国现代医学杂志,2015,25(17):70-77.
[20] 程琮,刘一志,王如德. Kendall协调系数W检验及其SPSS实现[J]. 泰山医学院学报,2010,31(7):487-490.
[21] 黄敬亨. 健康教育学[M]. 上海:上海医科大学出版社,1997:212.
[22] 赵学荣,张婕,陈艳. 运用德尔菲法和层次分析法建立新疆高职乡村医师专业学生职业认同指标体系[J]. 新疆医科大学学报,2013,36(3):406.
[23] 卢崇蓉,戴红蕾,朱文华,等. 基于提高岗位胜任力的全科适宜技术培训模式的探讨[J]. 全科医学临床与教育,2016,14(3):241-242.
[1] 赵玉遂, 许燕, 吴青青, 徐水洋, 徐锦杭. 应用德尔菲法构建网络健康信息质量评价指标体系[J]. 预防医学, 2018, 30(2): 121-124.
[2] 许燕, 郭俊香, 夏时畅, 胡伟, 陈士华, 叶真. 国家卫生城市综合评价指标体系研究[J]. 预防医学, 2016, 28(3): 247-251.
[3] 韦余东, 张人杰, 张新卫, 王臻, 刘碧瑶, 李娜, 张双凤. 应用德尔菲法构建疾控机构应急能力评价指标体系[J]. 预防医学, 2016, 28(1): 32-36.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed