Construction Of Personalized Health Care Model For The Elderly In Geriatric Nursing Facilities And The Development Of Supporting Platform

[Objective]1.Explore the key content of the elderly health problem evaluation system in China’s geriatric nursing facility at this stage,and determine the elderly health problem evaluation tool.2.Search the clinical practice guidelines related to elderly care in geriatric nursing facility at home and abroad,integrate the high-quality guideline recommendations with health problem as the recommended theme,and form the health care guidance scheme for the elderly.3.Integrate the results of the research group,design and develop the health support platform for the elderly in geriatric nursing facility with software engineers.[Methods]1.Use cross-mapping method to explore the feasibility of applying Omaha problem classification system in geriatric nursing facility in China based on 725 questionnaires of the elderly.Combined with literature research and Delphi expert inquiry method to constructs the health problem assessment tool for the elderly in geriatric nursing facility.Use convenience sampling method to select 100 elderly people from two geriatric nursing facility in Taizhou City for pre survey.The reliability and validity of scale were tested by relevant statistical methods,The Cronbach αCoefficient and Guttman split-half reliability was calculated for reliability analysis,and content validity was used for validity analysis.2.Systematically search the clinical practice guidelines related to elderly care in geriatric nursing facility in domestic and foreign guide databases.Use the AGREE Ⅱ tool to evaluate the quality.The preliminary care guidance program is summarized according to the steps of content analysis,subject classification,evidence extraction and evidence integration.The health problem guidance plan is established according to the applicability evaluation by expert suggestions3.The platform functional requirements framework and organizational structure are defined based on the results of the research group.Software engineers provide technical support,researchers conduct multiple rounds of functional testing,and cooperate to develop supporting platform for health care support platform for the elderly in geriatric nursing facility.[Results]1.Feasibility analysis:there are 5024 items involving health problems and symptoms or signs of the elderly among 725 questionnaires,3800 items are completely consistent,accounting for 75.6%,946 items are partially consistent,accounting for 18.8%,and 278 items are not consistent,accounting for 5.5%,the anastomosis rate was 94.5%.23 health problems and 61 symptoms or signs are used,and the overall application rates are 54.8%and 18.2%respectively.2.Expert inquiry:a total of 18 experts are consulted.The response rates of experts in two rounds are 100%and 94.4%respectively,and the expert authority coefficient is 0.89.The health problem assessment tool for the elderly in geriatric nursing facility is initially established,including 4 fields,28 health problems and 125 symptoms or signs.3.Reliability and validity test:100 elderly people are selected for the preliminary survey.The Cronbach’s a coefficient is 0.890,the Guttman’s half reliability coefficient is 0.830,the sub dimensions cronbach’s a coefficient are 0.703,0.783,0.787 and 0.737 respectively of the health problem assessment tool.Six experts are selected to evaluate the content validity.It is calculated that the I-CVI are from 0.83 to 1,S-CVI/UA is 0.88,S-CVI/ave is 0.98.4.Guideline quality evaluation:a total of 29 clinical guidelines are included for quality evaluation with ICC of 0.752 to 0.931.According to the quality evaluation,11 guidelines are A-level,15 guidelines are B-level and 3 guidelines are C-level.5.Evaluation of the applicability of the guidelines:six experts are selected to revise the guidelines,and finally a health problem guidance plan which including 86 recommendations,covering 4 areas,20 health problems of Omaha problem classification system is initially established.6.Platform development:the platform includes the web page end and the app with the function of online evaluation,dynamic summary and personnel management etc.[Conclusions]1.Omaha problem classification system has good feasibility in China’s geriatric nursing facility,and can be considered as the standardized language of China’s elderly care services.However,it needs to be revised and improved in combination with the current situation of China’s elderly care services and the characteristics of the elderly.2.The health problem assessment tools for the elderly in geriatric nursing facility include four fields:environment,psychosocial,physiological and health-related behaviors,28 health problems and 125 symptoms and signs,which have good reliability and validity,strong scientificity,reliability and authority.They can standardize the content of the elderly assessment and reflect the health status of the elderly systematically and comprehensively.3.The health care guidance program for the elderly in geriatric nursing facility includes four fields of environmental,psychosocial,physiological and health-related behaviors,20 health problems and 86 recommendations.It is scientific and clinically applicable,and can provide effective reference for the practice of geriatric nursing facility.It can be effectively linked with the early assessment tools,and accurately meet the needs of elderly care,Improve the quality of elderly care.4.The health care support platform for the elderly in geriatric nursing facility can realize online evaluation,dynamic summary and overall management,which is helpful for the managers to grasp the health status of the elderly as a whole,clarify the focus of care,and provide reference basis for the geriatric nursing facility to optimize the allocation of human and material resources.