Construction And Primary Implementation Of HIV Clinical Care Standard System And Quality Evaluation System

Objective(1) based on comfort theory to construct a clinical nursing care and quality evaluationstandard for AIDS patients so as to standardize nursing process and improve the quality ofAIDS patients care.(2) to evaluate the clinical care of AIDS patients by the evaluation standard for AIDSpatients, summarize and analyze effect factors, to improve the clinical care standard andquality evaluation system.MethodPart Ⅰ: construction of clinical nursing care standard and quality evaluation system forAIDS patients. Clinical care standardand quality evaluation system were constructed by usingDelphi Method on the basis of comfort theory. Meanwhile, a total of17experts from differenthospitals of infectious disease in China were invited for consultation. According to theexperts’ suggestions, the clinical nursing care standard and quality evaluation system will becarefully revised prior to its final determination.Part Ⅱ: On the basis of the clinical nursing care standard and quality evaluation systemthat mentioned earlier in the part I,,questionnaire of AIDS clinical care standard and qualityevaluation and questionnaire of patient’s satisfaction were designed for the clinicalevaluations. In-patients who met the inclusion criteria from July,2012to December,2012inFuzhou, were selected by cluster sampling. Current clinical nursing care for AIDS patientswere evaluated by on-the-ground assessment, and patients’ satisfaction about care byquestionnaire. Descriptive statistics, Pearson correlation analysis, etc were used, and patients’care quality and influential factors were analyzed.Result(1) Clinical care standard and care quality evaluation system for AIDS patients wereconstructed, including4dimensions which are environmental comfort, physical comfort,psychological comfort, and cultural comfort. They are further divided into7class-Ⅰindicators,21class-Ⅱindicators and48class-Ⅲ indicators. Experts mark the importance ofevery indicator andthe average value was between4.18～4.88with variance coefficient0.06～0.22.Kendall’s W is between0.12～0.19,P<0.05.(2) through Delphi method, questionnaire of clinical care standard and quality evaluation for AIDS patients, and questionnaire for patient’s satisfaction were formed. PearsonCorrelation was0.853in the retest reliability of “questionnaire of clinical care standard andquality evaluation for AIDS patient”, reliability ICC of markers was0.987. PearsonCorrelation was0.817in the retest reliability of “questionnaire for patient’s satisfaction”.（3） the105patients who have evaluated the indicators in the four dimensions of thequestionnaire and gave the highest score to environmental comfort which was4.97～5.00.The score in physical comfort was largely different. Higher score in symptomatic careincluded fever care4.99,cough and expectoration care4.81, prevention and care of oral cavity4.69,and so on. The low scores achieved were in care of genital herpes, wart, and condylomaacuminatum, and pain care. The lowest score was in nutritional support(2.95～3.07). Thescale of psychological comfort was largely different. The high scale was psychologicalsupport, while the scale of hospice care was low. The scale of cultural comfort was2.92～4.95, and from high to low were respect the religious beliefs of patients，health education andconstruction of support system.（4）for the105patients who have completed the questionnaire，they were less satisfiedwith nursing care, and the average value of every evaluation standard was3.0～3.5,thevariance coefficient is0.38～0.43.Conclusion（1）with comfort theory as a framework,based on present state of HIV clinical care inChina, clinical care standard and care quality system for AIDS patients was constructed frommultiple dimensions. This system was comprehensive and reasonably structured. Both thequestionnaire of clinical care standard and quality evaluation for AIDS patients, andquestionnaire of patient’s satisfaction had good reliability and validity. They can be used as atool to assess quality of care in clinic for AIDS patients.（2） from4dimensions of this system, we found that the effect of environmentalcomfort was best. The effect of physical comfort, psychological comfort and cultural comfortwas large different and in medium level.（3）Due to the level of hospital service, quality of nurses, disease severity and patient’sneed not fully satisfied, the patients’ satisfaction was generally not high.（4） the care standard system and evaluation system constructed in this study needed tobe implemented, tested and improved by a larger sample.