基层农村宫内节育器放置服务质量评价指标体系的初步构建

发布时间：2018-04-21 15:13

本文选题：基层农村IUD放置服务 + 质量评价指标体系　；参考：《昆明医科大学》2012年硕士论文

【摘要】：研究目的本研究旨在评价基层农村宫内节育器(Intrauterine device, IUD)放置服务质量,初步构建一套适合我国基层农村IUD服务发展现状,具有一定科学性和可行性的评价指标体系,以提高基层农村IUD放置服务规范化、科学化程度,为基层农村IUD放置技术服务质量评价实践提供一些方法学基础和建议,同时探讨系统聚类分析在Delphi专家筛选中的运用。研究方法本研究采用选题小组法,收集并分析影响基层农村IUD放置服务质量的关键因素,并在此基础上结合文献研究、专家论证初步提出基层农村IUD放置服务质量评价指标。利用德尔菲专家咨询法(Delphi method),在全国范围内咨询IUD放置服务及管理的相关专家,对选题小组法初步提出的指标进行重要性、可测量性、可行性评价,进而对指标进行筛选和确定权重,从而初步构建基层农村IUD放置服务质量评价指标体系。在本轮Delphi法专家咨询的基础上,运用系统聚类方法对专家可靠度进行分类及筛选,通过筛选前后协调系数的比较对分类筛选结果加以验证。研究内容本研究主要以基层农村IUD放置服务质量为评价对象,用定性和定量方法筛选指标,建立综合评价指标体系。主要内容包括：(1)在国内外相关理论、文献研究及课题前期关于云南省县／乡两级IUD放置服务现状和全面质量管理研究的基础上,就IUD放置服务质量评价指标的初步构建召开选题小组讨论会,针对“有哪些因素或方面可能影响基层农村IUD放置服务的质量?”这一主题,请参会人员根据自己的知识和经验,在小纸片上写出影响基层农村IUD放置服务质量或水平的关键因素,并对其重要性进行排序。然后课题组成员对参会人员提出的关键因素进行系统整理和分析,进而初步提出基层农村IUD放置服务质量评价指标。(2)通过专家论证和Delphi专家咨询法进一步筛选指标并计算指标的权重。通过网络检索、专家推荐等方式,课题组确定拟咨询的专家,同时根据指标重要性的一致性分析结果和文献回顾,开发出第1轮德尔菲法咨询的调查表,包括三个部分,即专家评分表、专家信息表和开放式问卷。之后发放、回收、整理和录入、分析专家咨询调查表。最后结合Delphi问卷分析结果和专家讨论对指标进行进一步精选和确定权重。(3)在本轮Delphi法专家咨询的基础上,运用系统聚类方法对专家可靠度进行分类及筛选,通过筛选前后协调系数的比较对分类筛选结果加以验证。研究结果 (1)通过选题小组法初步提出基层农村IUD放置服务质量评价指标,评价指标分三级：一级指标3个,二级指标11个,三级指标59个 (2)第1轮Delphi专家咨询的积极系数为86.3%,专家权威系数65%。通过上述一系列的研究活动,结合专家评议与课题组讨论初步构建了以IUD放置质量、基础管理工作质量和医疗过程工作质量三大类指标为主要结构的具有层次性的指标体系,包括一级指标3个、二级指标11个、三级指标39个。其中IUD放置质量指标包括放置前、放置中、放置后等3个二级指标；基础管理工作质量指标包括机构、人员、技术培训、规章制度、设备和物资保障等6个二级指标；医疗过程工作质量指标包括诊疗服务的能力以及咨询技术的能力等2个二级指标；三级指标在此不一一赘述。 (3)运用系统聚类方法将63名咨询专家筛选出17人。筛选后45.46%指标协调系数升高,差异有统计学意义(Z=-4.70,p0.01)。研究结论基于上述研究结果,本研究得出了以下几点结论(1)建立的指标体系层次分明,覆盖全面,有效、可信、可操作(2)指标的筛选方法合理(3)确定指标权重系数的方法科学、结果相对准确(4)在德尔菲法中,运用系统聚类分析筛选专家、提高协调系数、经过较少的Delphi法专家咨询次数、获得较可靠的专家意见是可行的。(5)定性与定量的有机结合是构建指标体系的有效方法(6)该评价指标体系还需在今后的研究中进一步修订、考核、验证和完善。
[Abstract]:research objective
The purpose of this study is to evaluate the quality of Intrauterine device (IUD) in grass-roots rural areas, and to establish a set of evaluation index system which is suitable for the development of rural IUD service in grass-roots rural areas, which is scientific and feasible, in order to improve the standardization and scientific degree of IUD placement service in grass-roots rural areas, and to place IUD in grass-roots rural areas. The practice of technical service quality evaluation provides some methodological foundations and suggestions, and discusses the application of systematic cluster analysis in Delphi expert screening.
research method
This study uses the topic selection group method to collect and analyze the key factors affecting the quality of IUD placement service in grass-roots rural areas, and on this basis, based on the literature research, the expert demonstrates that the quality evaluation index of the IUD placement service in the grass-roots rural areas is preliminarily proposed. Using the Delphy expert consultation method (Delphi method), the service and management of IUD is consulted throughout the country. The relevant experts are important, measurability and feasibility evaluation, and then screening and determining the weight of the index, so as to preliminarily construct the evaluation index system for the quality of IUD placement service in the grass-roots rural areas. On the basis of the expert consultation of the Delphi method, the system clustering method is applied to the experts to be reliable. Classification and screening were carried out, and the results of classification and screening were verified through comparison of coordination coefficients before and after screening.
research contents
This study mainly takes the quality of IUD in the grass-roots rural areas as the evaluation object and uses qualitative and quantitative methods to select indicators and establish a comprehensive evaluation index system. The main contents include: (1) the related theories at home and abroad, literature research and the foundation of the research on the status of IUD placement service and the comprehensive quality management in Yunnan county / township level two level On the topic of "what factors or aspects may affect the quality of IUD placement service in grass-roots rural areas?" on the topic of "what factors or aspects may affect the quality of service in the grass-roots rural areas?" on the theme of "what factors or aspects may affect the quality of service in the grass-roots rural areas", the participants, according to their own knowledge and experience, write out the impact on the quality or level of IUD placement services in grass-roots rural areas, according to their knowledge and experience. The key factors, and sort the importance of its importance, and then the team members of the key factors put forward by the participants systematically and analyzed, and then preliminarily put forward the quality evaluation index of the IUD placement service in the grass-roots rural areas. (2) through the expert demonstration and Delphi expert consultation method to further screen the index and calculate the weight of the index. At the same time, according to the results of the consistency analysis of the importance of the index and the literature review, we developed a questionnaire for first rounds of Delphi consultation, including three parts, namely, the expert rating scale, the expert information table and the open questionnaire. In the end, the index is further selected and determined by Delphi questionnaire analysis results and expert discussion. (3) on the basis of the expert consultation of the present round Delphi method, the system clustering method is used to classify and screen the expert reliability, and the results are verified by the comparison of the number of coordination lines before and after screening.
Research results
(1) the quality evaluation index of IUD placement in grass-roots rural areas is preliminarily proposed through the selection group method. The evaluation index is divided into three levels: 3 first grade, 11 of two grade and 59 for grade three.
(2) the positive coefficient of the first round Delphi expert consultation is 86.3%. The expert authority coefficient 65%., through a series of research activities, and the discussion of the expert review and the topic group, preliminarily constructs a hierarchical index system with the quality of IUD placement, the quality of the basic management work and the quality of the medical process work as the main structure. There are 3 level indicators, two level indicators 11, three level indicators 39. Among them, IUD placement quality indicators include 3 two levels before placement, placement, and post placement; the quality indicators for basic management include 6 two levels, including institutions, personnel, technical training, rules and regulations, equipment and material support, and medical process quality indicators include diagnosis. There are 2 two level indicators, such as the ability to cure services, the ability to consult technology, and the three level indicators.
(3) using systematic clustering method, 17 experts were screened out by 63 consultation experts. After the screening, the coordination coefficient of 45.46% indicators increased, the difference was statistically significant (Z=-4.70, P0.01).
research conclusion
Based on the above research results, this study draws the following conclusions (1) the establishment of the index system is clear, covering comprehensive, effective, reliable, and reliable, and the selection method of the operational (2) index is reasonable (3) to determine the index weight coefficient method science, the result is relatively accurate (4) in Delphi method, using the system cluster analysis to screen experts and improve the Coordination Department Number, it is feasible to obtain more reliable expert advice through fewer Delphi expert consultation times. (5) the organic combination of qualitative and quantitative is an effective method to construct the index system (6) the evaluation index system needs to be further revised, examined, verified and perfected in the future research.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R169.4

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