德尔菲法指标体系构建到底应该怎么样做？

小小lar89fh1mk 2020-11-28

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这是一篇指标体系构建的经典文献，值得各位老师去阅读和学习。

以下是摘要部分

ABSTRACT

Background: The number of patients withdiabetes has been increasing rapidly according to a 2017 report by theInternational Diabetes Federation. Diabetes has become one of the mostchallenging public health problems, and there will be an estimated 143 millionpatients with diabetes in China by 2035. This puts considerable pressure onnurses who specialize in the care of patients with diabetes in China andincreases related social and financial burdens. Clinical practice has proventhat strengthening the core competencies of nurses and establishing anevaluation system of core competencies improve both healthcare quality andpatient quality of life. However, no core-competence system framework currentlyaddresses the unique characteristics of nurses in China.

背景：根据国际糖尿病联合会2017年的一份报告，糖尿病患者的人数一直在迅速增加。糖尿病已经成为最具挑战性的公共卫生问题之一，到2035年，中国估计将有1.43亿糖尿病患者。这给专门从事中国糖尿病患者护理工作的护士带来了巨大压力，并增加了相关的社会和财务负担。临床实践证明，加强护士的核心能力并建立核心能力评估系统可以改善医疗质量和患者生活质量。但是，目前还没有核心竞争力系统框架能够解决中国护士的独特特征。

Purposes: The purpose of this study was toconstruct a core- competence system framework for primary nurse specialists indiabetes care.

目的：本研究的目的是为糖尿病护理的初级护士专家建立一个核心能力系统框架。

Methods: A brainstorming approach was conducted that worked to conceptualize the core competencies of nurse specialistsin diabetes care in China. Next, a study group organized this information andconducted a seminar; 50 experts and patients with diabetes were invited todevelop the first draft of the framework. Afterward, 50 experts were selected to participate in the Delphi survey. Most indicators were retained after athree-round Delphi process, and the superiority chart was used to determine theweights of the six dimensions.

方法：进行了头脑风暴方法，以概念化中国糖尿病护理专业护士的核心能力。接下来，一个研究小组组织了这些信息并举办了一次研讨会。邀请了50位糖尿病专家和患者来制定框架的初稿。之后，选择了50名专家参加Delphi调查。经过三轮Delphi处理后，大多数指标得以保留，优势图表用于确定这六个维度的权重。

Results: Forty-seven experts completed theconsultation. The experts' rate of response ranged from 94% to 100%, the authoritycoefficient was .91, and the Kendall's coefficients of concordance in Grades1–3 were .793, .418, and .542, respectively. An increasingly detailed,three-grade system framework was developed, including six first-gradeindicators (diabetes professional knowledge, diabetes-related knowledge,communication skills and health education ability, specialized skills, clinicaljudgment, and specialty development capacity), 23 second-grade indicators, and87 third-grade indicators. The weights of the six first-grade indicators were.221, .149, .192, .209, .160, and .069, respectively.

结果：47位专家完成了咨询。专家的回应率从94％到100％不等，权威系数为0.91，而1-3级的肯德尔一致性系数分别为0.793，0.418和0.542。开发了越来越详细的三级系统框架，包括六个一级指标（糖尿病专业知识，糖尿病相关知识，沟通技能和健康教育能力，专业技能，临床判断和专业发展能力），六个一级指标的权重分别为0.221，0.149，0.192，0.209，0.160和0.069。二级指标：23个指标；三年级指标：87个。

Conclusions: The core-competence systemframework includes six core competencies, which represent the main characteristicsof primary nurse specialists in diabetes care who are highly recommendedby experts. It is important to keep in mind that this is only a theoreticalframework and thus must be further tested in clinical practice settings inChina.

结论：核心能力体系框架包括六个核心能力，这些代表了糖尿病专家的强烈推荐，代表了糖尿病护理初级护士的主要特征。重要的是要记住，这只是一个理论框架，因此必须在中国的临床实践环境中进行进一步的测试。

通过阅读以上这篇文献，让我们回顾一下德尔菲法指标体系构建需要注意的事项：

1.需要有理论基础，比如本文中是有明确的理论基础的。

Theoretical basis：This study was based on the British “integrated career and competencyframework for diabetes nursing” model (Trend, 2011).Toaddresstheroleofnursespecialistsindiabetescare in China as educators,the framework referred to some rele- vant studies of the AADE(2011) and the Australian DiabetesEducators Association (2008). In addition, domestic nurses inemergencycare,peripherallyinsertedcentralcathetercare,intensivecareunits,andotherspecialties(Fan&Xi,2011;Yao, 2012) providedbasic information for thisstudy.

2、依照理论构建自己研究的指标框架

Development ofthe first draft of the framework

After the brainstorming phase, the Project ExecutionTeam organizedtheinformationandheldaseminartodetermine

the first draft of the corecompetence framework. The 50

participantsin this seminar included three diabetologists, 37nursespecialistsindiabetescare,fivenursingmanagers, and five patients withdiabetes.

3.招募咨询专家，一般是30-50个专家，注意专家的专业性和权威性，还需要考虑专家的分布区域。

Expert panel selection and recruitment

Fifty diabetes experts from 28 provinces and municipalities joined the expert panel to (a) balance the differences amongregions and (b) maximize information diversity to make the framework moreuniversal and comprehensive. The experts included clinical diabetes nursespecialists, nursing managers, and diabetologists who had 10 years or more ofexperience in diabetes treatment and care.

4.Likert 评分方法是德尔菲专家咨询法重要的评分方法

Data Collection

The Project Execution Team applied theDelphi method (Aljamal, Ashcroft, & Tully, 2016) to carry out three roundsof consultation between October 2015 and March 2016. In the first round,experts gave their advice on the first draft of the framework, with advicefocused mainly on the deletion, addition, or modification of indicators. In thesecond round, experts continued to provide new suggestions and assigned a valueto all of the indicators based on a 5-point Likert scale from 5 = very importantto 1 = not important. Afterward, group members readjusted and formed new indicatorsbased on the following screening criteria: mean > 3.5, coefficient ofvariation < 0.25, and expert approval rate > 70% (Guo, 2005; Wu, 2011).The third round mirrored the process inthe second round and assigned weights to the first-grade indicators using thesuperiority chart (Cabral et al., 2005). All of the opinions were summarized toform the core competencies of primary nurse specialists in diabetes care.

6.数据结果统计中需要注意统计学方法的使用，比如专家一致性协调系数（-Kendall's coefficient of concordance (W)。专家的权威系数等。

Data Analysis

Microsoft Excel 2007 (Microsoft,Redmond, WA, USA) and IBM SPSS Statistics 17.0 software (SPSS, Inc., Chicago,IL, USA) were used to conduct data analysis and processing. Data were presentedas means and standard deviations for continuous variables. In general, theauthoritative coefficient (Cr) is composed on the basis of expert judgment (Ca)and of familiarity with the questions (Cs). The formula is Cr = (Ca + Cs) / 2. The valueof Ca and Cs is obtained mainly through expert self-evaluation. The variablesCa and Cs reflect, respectively, the judgment and familiarity of the expertswith regard to survey content. Kendall's coefficient of concordance (W) refers to the level of intra expert agreement on all of the indicators. A nonparametrictest was applied for Kendall's coefficient of concordance (W).