| ObjectivesConstructing the demand index system of the remote nursing services for the cerebral stroke patients.Understanding the demand situation of the cerebral stroke patients for the remote nursing services and its influencing factors,carrying out the attribute classification and optimization ranking of remote nursing service requirements,providing a reference for the effective implementation and scientific development of the remote nursing services.Methods1.The requirements and contents of the remote nursing services for the cerebral stroke patients are analyzed and classified by literature analysis and semi-structured interview,and then,an index pool was constructed.The indexes were preliminarily screened through the content validity index method,and the initial index system of the remote nursing services for the cerebral stroke patients was formed.2.Through the Delphi method,the initial index system of the remote nursing services demand of the cerebral stroke patients was modified and improved to determine the index system.Based on the analytic hierarchy process,the Yaahp software was used to construct the hierarchical model and judgment matrix,then,determine the index weight and test the consistency.3.A questionnaire was designed by the index system to investigate 200 cerebral stroke patients in three general hospitals in Kaifeng.Further,the Cronbach’s α was selected to test the consistency of the questionnaire,and validity of the questionnaire was tested by factor analysis.4.Analyzing the degree of patients’ demand for the remote nursing services,and clarify the influencing factors of the survey results.5.The KANO model and matrix analysis were used to the attribute classification and optimization ranking for the remote nursing services demand of the cerebral stroke patients.Results1.Through literature review,semi-structured interview and content validity index method,an initial index system with 5 dimensions and 21 indicators is constructed in this paper.2.After two rounds of the Delphi expert consultation,the index system has been modified and improved.The expert positive coefficient is 95% and 100% respectively,and the expert authority degree coefficient is 0.92.The Kendall harmony coefficients of the two rounds consultation were 0.339 and0.445 respectively,and P<0.05.Finally,the demand index system of the remote nursing services for the cerebral stroke patients with 5 dimensions and 20 indicators was constructed,and the 5 dimensions include ‘disease care services’,‘prevention and rehabilitation’,‘diversified psychological nursing’,‘online information services’,and ‘emergency care and first aid’.The analytic hierarchy process shows that the weights of the 5 dimensions are 0.1854,0.3229,0.1065,0.1405 and 0.2447 respectively.The weight assignment of each index is between 0.0151-0.1207,and the CR is between 0.0077-0.0516.The judgment matrix passes the consistency test.3.The reliability test results of the demand questionnaire: the Cronbach’s α coefficient is 0.936,and the reliability coefficients of the 5 dimensions are greater than 0.7.The validity test results: the KMO value is 0.785,and the significance probability of the spherical test statistic is less than 0.001.The factor analysis divides the original variables into five categories,which is exactly consistent with the five factors structure by the questionnaire design4.The scores of the five dimensions of the demands for the remote nursing servicess were:disease care services(4.05±0.439),prevention and rehabilitation(4.33±0.542),diversified psychological nursing(4.04±0.678),online information services(4.12±0.576)and emergency care and first aid(4.52±0.550).The results of influencing factors analysis showed that ‘age’,‘education level’,‘medical payment method’,‘monthly income’,‘marital status’ and ‘primary caregiver’ are the factors which affect the patient’s demand score(P<0.05).5.The analysis results of demand qualities of the remote nursing servicess are: 6 Attractive Qualities,6 One-dimensional Qualities,7 Must-be Qualities,an Indifferent Quality,no Reverse Quality.Combined with the results of attribute classification,the matrix diagram is drawn.There are 5 indicators in the first quadrant,6 indicators in the second quadrant,2 indicators in the third quadrant,7 indicators in the fourth quadrant.Conclusions1.In this study,the construction of the index system can provide a basis for the investigation of the remote nursing services demand of the cerebral stroke patients.2.The remote nursing services demand questionnaire for the cerebral stroke patients has good reliability and validity.Therefore,the questionnaire has certain application value.3.The cerebral stroke patients have a high demand for distance care services,which is affected by the factors of ‘age’,‘education level’,‘medical payment method’,‘monthly income’,‘marital status’ and ‘primary caregiver’.4.First of all,establish and improve ‘online information service’(Must-be Qualities)for the development of the remote nursing services.Furthermore,‘prevention and rehabilitation’ and‘emergency care and first aid’(One-dimensional Qualities)servicess need to be developed with great effort.At the same time,‘disease care service’ and ‘diversified psychological nursing’(Attractive Qualities)should be paid attention to. |
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