| Objectives:Based on the current policy documents issued by the state and Yunnan Province,and drawing on the standards of home care services in advanced provinces and cities in China,based on the actual situation of home care services in Yunnan Province,the Home Care Service Standards of Yunnan Province are compiled to promote the development of home care services in our province.And standardized construction to promote scientific decision-making by relevant government departments.Methods:1.Using the literature analysis method,review the domestic old-age service policies and standardized documents,guided by the theory of behavioral system model,referring to professional books in the fields of medicine,nursing,psychology,etc.,and combine with the actual situation in Yunnan Province to compile the "Home Care Service Standard of Yunnan Province".2.Using Delphi expert consultation method,semi-structured interview method,two rounds of expert consultations were conducted on 18 experts in the field of elderly care services,and a round of semi-structured interviews were conducted with 7 experts to collect opinions on the revision of the service standard and improve the standard,then using the analytic hierarchy process to calculate the weight of each service item.3.Select 20 research subjects and 5 experts to participate in the compilation of the "Expert Review Questionnaire "and conduct reliability and validity tests.Four experts in the field of elderly care services were selected,and the "Expert Review Questionnaire" was used to conduct an expert review of the "Home Care Service Standard of Yunnan Province" to evaluate the quality of the service standards in multiple dimensions.Results:1.With reference to national standard documents and the service standards that have been implemented in the field of home care for the elderly in Beijing,Shanghai,Zhejiang,Tianjin and other 10 regions,prepare the "Home Care Service Standard of Yunnan Province",including 15 first-level service items,128 second-level service items.Referring to the contents of Zhejiang Province’s "Standard for Home-based Elderly Care Services" and "Basic Nursing","Medical Nursing","Geriatric Nursing"and other professional books to compile contents of the standard.the contents of the services standard are written in three ways include characters,picture and graph.Most of the service items are presented in four parts:applicable people/scope,service requirements,service processes and precautions.2.A total of 18 experts participated in Delphi expert consultation,mainly engaged in clinical work in geriatrics,management of elderly care services and scientific research.The positive coefficients of the experts in the two rounds of Delphi expert consultations were 94.74%and 83.33%,the expert authority were 0.906 and 0.914,and the expert opinion coordination coefficients W were 0.315(χ2=806.316,P<0.001),0.356(x2=714.866,P<0.001),two rounds of consulting proposed a total of 36 amendments and 28 were adopted.The final standard include 14 first-level service items and 117 second-level service items.The first-level service items are sorted in order of weight:home care service management norms,daily work norms,accident prevention and emergency assistance norms,health management service norms,diet and elderly canteen service norms,companionship and mental health service norms,disinfection and isolation services Norms,norms of hospice care services,norms of cleaning services,norms of mobile and assisted services,norms of law-related services,norms of housekeeping services,norms of modification services,norms of community activities and training management.3.Prepare the "Expert Review Questionnaire" with reference to AGREE Ⅱ,which contains 5 dimensions,11 items,and two overall evaluation indicators.The retest reliability of the questionnaire was 0.871,the I-CVI of the questionnaire was 1.00,and the S-CVI was 1.00,which had good reliability and validity.A total of 4 experts participated in the expert review to calculate the standardized scores for each dimension.The standardization score of the "Scope and Objects" dimension and the"Clearness" dimension of the services standard are 93.75%,the "Rigority" dimension score is 90.63%,the "Practicability" dimension score is 87.50%,and the "Participant"score is 75.00%(All>60%);the total standard quality score is 87.50%,and the 4 experts gave a "recommended" evaluation opinion.Conclusions:1.This study is guided by the theory of behavioral system model,and refers to the domestic standard documents for home care services and professional books to prepare the first draft of home care service standard in Yunnan Province.Carry out two rounds of Delphi expert consultations and one round of semi-structured interviews,modify and improve the home care service specification.Finally,the"Home Care Service Standard of Yunnan Province" was completed with 14 primary service items and 117 secondary service items.2.The results of Delphi’s expert consultation in this study show that the level of expert enthusiasm and authority are high.After the two rounds of consultation,the degree of coordination of expert opinions is high.A comprehensive evaluation of services standard was conducted using the self-edited "Expert Review Questionnaire",and the results showed that the standardized scores in all dimensions were greater than 60%.Experts gave "recommendations".The overall quality of "Home Care Service Standard of Yunnan Province" is good and can be promoted and used in Yunnan Province.3."Home Care Service Standard of Yunnan Province" prepared in this study is the first service specification for home care in Yunnan province.It has a guiding role in home care service work and the training of old-age service personnel in our province,to provide a basis for the scientific management of home care services,and to promote the construction of a standard system of care services for the elderly in our province.The results of this study put forward the following suggestions to relevant departments:(1)Expand the coverage of home care services and improve the fairness of services and policies;(2)Enrich the content of home care services,innovate service models,and improve service supervision mechanisms;(3)Speed up construction of communities and service teams to improve service quality and satisfaction;(4)Clarify the functions of various departments and accelerate the construction of a standardized system for pension services. |
