Abstract:

Objective　To construct an evaluation index system for the effect of health education on chronic kidney disease, and to provide a reference basis for formulating and carrying out health education work. Methods　The relevant literatures on the evaluation index system for the effect of health education on chronic kidney disease established in Cochrane, PubMed, Web of Science, CNKI, Wanfang, and VIP from the establishment of the databases to June 2023 were searched by computer. Finally, 80 literatures were selected, and 6 first-level indicators were obtained (satisfaction effect, education effect, management effect, economic effect, social effect, and sustainable development). On the basis of literature retrieval, with reference to the local standards of Specification for Health Education on Chronic Kidney Disease and the evaluation index system model of "audience-social-economy-sustainability", and combined with the actual work of health education, an evaluation index system for the effect of health education for chronic kidney disease (6 first-level indicators and 20 second-level indicators) was initially developed. The expert letter questionnaire was made, including the foreword, the expert basic information questionnaire, the expert familiarity and judgment basis, and the expert opinion table. From August to September 2023, two rounds of questionnaires were sent to 28 experts with an interval of two weeks. After the end of the first round of expert correspondence, the research team made modifications according to the experts' opinions and the screening principle of indicators, and the second round of expert correspondence questionnaire was formed. χ² test was used for statistical analysis, enthusiasm was represented by questionnaire recovery rate and opinion proposal rate, authority was represented by authority coefficient, coordination degree and consistency were represented by Kendall harmony coefficient and variation coefficient, and analytic hierarchy process was used to determine the weights of the first-level and second-level indicators. Results　A total of 28 experts in the field of chronic kidney disease and science popularization were included in this study, including 8 males and 20 females; age: ≥30 - <35 years old in 14 cases, ≥35 - <40 years old in 5 cases, and ≥40 years old in 9 cases; education: bachelor's degree in 17 cases, master's degree in 5 cases, and doctor's degree in 6 cases; working years: <10 years in 17 cases, ≥10 - <20 years in 5 cases, and ≥20 years in 6 cases; professional titles: intermediate in 9 cases, associate senior in 15 cases, and senior in 4 cases; frequency of health education activities: once or twice a day in 8 cases, once or twice a week in 6 cases, once or twice a month in 8 cases, once or twice a quarter in 4 cases, and once or twice a year in 2 cases. The recovery rates of the two rounds of questionnaires were 100.00%(28/28) and 92.86%(26/28), respectively. In the first round of expert correspondence, 16 experts gave their opinions in written or oral form, accounting for 57.14%. The expert authority coefficients of the two rounds were 0.804 and 0.839, respectively. The Kendall harmony coefficients of the first-level and second-level indicators in the first round of expert correspondence were 0.263 and 0.211, respectively, and 0.316 and 0.272 in the second round, with statistically significant differences between the two rounds (all P<0.05). The variation coefficients of the first-level indicators in the first round of expert correspondence were 0 - 0.196, without addition or deletion; the variation coefficients of the second-level indicators were 0 - 0.286, and 4 items of the second-level indicators were modified. In the second round of expert correspondence, there were no additions or deletions to the first-level or second-level indicators. Finally, an evaluation index system for the effect of health education on chronic kidney disease including 6 first-level indicators and 27 second-level indicators was constructed. The weights of satisfaction and education effect were both 0.173, 0.172 of management effect, 0.170 of economic effect, 0.163 of social effect, and 0.018 of sustainable development effect. Conclusion　The formulation of the evaluation indexes for the effect of health education on chronic kidney disease is scientific, reasonable, comprehensive in content, and highly targeted, which can be used to evaluate health education activities for patients with chronic kidney disease.

Key words:

Chronic kidney disease, Health education evaluation, Delphi method, Analytic hierarchy process

摘要：

目的　构建慢性肾脏病健康教育效果评价指标体系，为开展健康教育工作提供参考依据。方法　计算机检索Cochrane、PubMed、Web of Science、中国知网、万方和维普等数据库中建库至2023年6月慢性肾脏病健康教育效果评价指标体系的相关文献。最终筛选文献80篇，得到一级指标6个（满意度效果、教育效果、管理效果、经济效果、社会效果、可持续发展）。基于文献检索基础，参照《慢性肾脏病健康教育规范》地方标准及“观众-社会-经济-可持续”评估指标体系模型，结合健康教育工作实际，初步拟定慢性肾脏病健康教育效果评价指标体系（一级指标6个，二级指标20个）。制作专家函询问卷，包括卷首语、专家基本信息调查表、专家熟悉程度与判断依据、专家意见表。于2023年8月至9月，采用电子邮件发放专家函询问卷，函询2轮，间隔时间为2周。第1轮专家函询结束后，研究小组根据专家意见和指标筛选原则进行修改，形成第2轮专家函询问卷。采用χ²检验进行统计学分析；积极性采用问卷回收率和意见提出率表示；权威性采用权威系数表示；协调程度及一致性分别采用肯德尔和谐系数、变异系数表示；采用层次分析法确定一、二级指标权重。结果　本研究共纳入慢性肾脏病及科普领域专家28名，男8名，女20名；年龄：≥30～<35岁14名，≥35～<40岁5名，≥40岁9名；学历：本科17名，硕士5名，博士6名；工作年限：<10年17名，≥10～<20年5名，≥20年6名；职称：中级9名，副高级15名，正高级4名；健康教育活动频率：每天1～2次8名，每周1～2次6名，每月1～2次8名，每季度1～2次4名，每年1～2次2名。2轮专家函询问卷回收率分别为100.00%（28/28）、92.86%（26/28）。在第1轮专家函询中，有16名专家以文字或口头形式提出意见，占比57.14%。2轮专家权威系数分别为0.804、0.839。第1轮专家函询中的一、二级指标肯德尔和谐系数分别为0.263、0.211，第2轮为0.316、0.272，两轮比较，差异均有统计学意义（均P<0.05）。第1轮专家函询一级指标变异系数为0～0.196，无增删；二级指标变异系数为0～0.286，修改4项。第2轮专家函询一、二级指标均无增删，最终构建包括6个一级指标和27个二级指标的慢性肾脏病患者健康教育效果评价指标体系。满意度及教育效果权重均为0.173，管理效果为0.172，经济效果为0.170，社会效果为0.163，可持续发展效果为0.018。结论　慢性肾脏病健康教育效果评价指标体系科学合理，内容全面，针对性强，可用于评价慢性肾脏病患者健康教育活动。

关键词:

慢性肾脏病, 健康教育评价, 德尔菲法, 层次分析法