| Objective:This study was designed to explore the status and needs of transitional care(TC)in patients with maintenance hemodialysis(MHD),and to explore their attitudes on mobile health information platform for TC,and on top of this,combined with the TC model of hospital-community-family three-dimensional linkage,to build a module system of TC information platform for MHD patients.The purpose was to provide comprehensive,real time and professional TC for patients with MHD by using the emerging mobile information technology and relying on health resources of hospital medical association area,and to provide reference for the future construction of mobile-health-based TC service model for patients with MHD.Methods:1.Literature review: by searching databases at home and abroad,relevant literatures on MHD patient TC were collected to provide a theoretical source for the content construction of the platform module.2.Qualitative study: carried out on the 11 patients with MHD were interviewed in depth by semi-structured interview.The purpose was to explore the status and needs of transitional care(TC)in patients with MHD,and to explore the preferences of MHD patients for different forms of TC,and to obtain suggestions on the construction and use of the mobile medical-based TC information platform.3.Delphi method:On the basis of literature research and qualitative interview research,and discussion in the research group,the module content of the information platform of TC for patients with MHD based on mobile health was initially formulated,and the module content were further demonstrated and revised by Delphi method.The 18 experts which from 6 fields of nursing education,nursing management,nephrology medicine,blood purification center,health informatics and community health service were interviewed by questionnaire in two rounds.In the first and second rounds,20 and 18 expert consultation questionnaires were issued,and required experts to score the importance and feasibility of indicators at all levels and propose Suggestions for modification.4.Statistical analysis method:The research group used Excel 2019 and SPSS26.0 to statistically analyze the mean,standard deviation,full score ratio,coefficient of variation and the Kendall’s concordance coefficient(Kendall’s W)of the two rounds of index scores.According to the screening criteria of indicators and experts’ opinions,a group discussion was conducted to delete,add and modify the modules and items and finally to determined the module content of the information platform of TC for patients with MHD based on mobile health.Results:1.Through the qualitative research of patients with MHD,a total of six themes were extracted:(1)needs of knowledge regarding disease..(2)needs of health guidance.(3)needs of doctor-patient communication.(4)needs for social or family support.(5)diversification of TC style demand,mainly by telephone and network.(6)having a high willingness to use the TC information platform based on mobile medical care,and wish that the software platform can meet their needs.2.On the basis of previous literature review and qualitative research,by consulting literature guidelines,comparing relevant results and group discussion,the contents of the module of TC information platform based on mobile health for patients with MHD were initially constructed,including 4 first-level indicators,19second-level indicators and 77 third-level indicators.After two rounds of experts consultation,the content system of the TC information platform module based on mobile health for patients with MHD was finally determined,including 3 first-level indicators,18 second-level indicators and 82 third-level indicators.The positive coefficients of the two rounds of experts consultation were 90.00% and 100%respectively,the proportion of experts who had given opinions were 66.67% and27.78% respectively,and the coefficient of expert authority was 0.85.After two rounds of consultation,the variation coefficient of the importance of each indicator fluctuated between 0.00% and 21.22%,the variation coefficient of the feasibility between 0.00% and 24.77%,and the Kendall’s W fluctuated between 0.301 and0.460.The chi-square test showed statistically significant differences(P < 0.05).Conclusions:1.Maintenance hemodialysis patients have higher demand for TC.So medical care personnel should be according to the requirements of patients,rationally utilizing health resources of hospitals and community with the help of new Internet technologies such as information platforms and wearable devices.It’s in order to provide personalized,professional TC services for MHD patients,and to extend their survival,improve their ability of self management and quality of life.2.In this study,Delphi expert consultation method was adopted to finally determine the module content system of the information platform of TC for patients with MHD based on mobile health,which including 3 first-level indicators,18second-level indicators,and 82 third-level indicators.The consultation experts have high professional representativeness and authority,and the experts also have good enthusiasm for the study.At the same time,the experts’ opinions are relatively coordinated and concentrated.The module content thus constructed is scientific and reliable,which provides a basis for the further development of the information platform and the promotion of the research results. |
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