Table 3.
Evaluation Duty Index System for the Index of Practices Scope for Community Nurses in Home-based Transitional Caring of Chronic Diseases.
| Indicators | Importance score (mean ± standard deviation) | Coefficient of variation | Weight | Combination weight |
|---|---|---|---|---|
| 1. The practitioner of continuing care | 5.00 ± 0.00 | 0.000 | 0.192 | — |
| 1.1 The continuation of the hospital continuity care program in the home setting | 4.93 ± 0.27 | 0.054 | 0.095 | 0.018 |
| 1.1.1 Scientific formulation and effective implementation of nursing measures for patients at home | 4.86 ± 0.36 | 0.075 | 0.095 | 0.002 |
| 1.2 Observation on the prognosis of the disease | 4.93 ± 0.27 | 0.054 | 0.038 | 0.007 |
| 1.2.1 Understand and master patient information (condition) | 4.79 ± 0.43 | 0.089 | 0.015 | 0.000 |
| 1.2.2 Monitor changes in the condition and make a referral if necessary | 4.43 ± 0.51 | 0.116 | 0.008 | 0.000 |
| 1.2.3 Understand care needs and help patients recover | 4.79 ± 0.58 | 0.121 | 0.015 | 0.000 |
| 1.3 Consultation and assessment of patients’ health needs | 4.64 ± 0.50 | 0.107 | 0.060 | 0.011 |
| 1.3.1 Assessment of risk factors for home health care | 4.57 ± 0.65 | 0.141 | 0.012 | 0.000 |
| 1.3.2 Accurate assessment of health environment and disease changes of home patients | 4.36 ± 0.63 | 0.145 | 0.031 | 0.000 |
| 2. Facilitators of patient involvement in disease self-management | 5.00 ± 0.00 | 0.000 | 0.167 | — |
| 2.1 Guide patients to master the appropriate operational techniques of self-care | 4.86 ± 0.36 | 0.075 | 0.013 | 0.002 |
| 2.1.1 Promote patients to master self-monitoring of disease, such as blood pressure, blood sugar monitoring at home | 4.86 ± 0.36 | 0.075 | 0.013 | 0.000 |
| 2.2 Guide patients to understand and master the theoretical knowledge of self-care | 4.79 ± 0.43 | 0.089 | 0.116 | 0.019 |
| 2.2.1 Personalized self-care knowledge (basic self-care ability, drug use ability, self-rescue ability) | 4.71 ± 0.47 | 0.099 | 0.101 | 0.002 |
| 2.2.2 Promote patients to master the prevention and care of disease complications | 4.71 ± 0.47 | 0.099 | 0.015 | 0.000 |
| 2.3 Improve patients’ compliance to treatment and rehabilitation | 4.79 ± 0.43 | 0.089 | 0.039 | 0.007 |
| 2.3.1 Help patients with positive psychological construction | 4.64 ± 0.50 | 0.107 | 0.013 | 0.000 |
| 2.3.2 Encourage patient participation in disease management | 4.71 ± 0.47 | 0.099 | 0.005 | 0.000 |
| 2.3.3 Help patients understand the benefits of good adherence | 4.21 ± 0.70 | 0.166 | 0.020 | 0.000 |
| 3. Organizer of community group intervention | 4.86 ± 0.36 | 0.075 | 0.211 | — |
| 3.1 Connecting “partnerships” for patients | 4.79 ± 0.43 | 0.089 | 0.070 | 0.015 |
| 3.1.1 Carry out peer education to improve patients’ confidence in curing diseases | 4.71 ± 0.47 | 0.099 | 0.035 | 0.001 |
| 3.1.2 Propose interventions for risk factors | 4.57 ± 0.65 | 0.141 | 0.035 | 0.001 |
| 3.2 Carry out group health science popularization activities | 4.86 ± 0.36 | 0.075 | 0.141 | 0.030 |
| 3.2.1 Carry out multi-angle and multi-channel popularization of science, establish network platforms (WeChat, QQ, corporate WeChat, etc.), TV broadcasts, and publicity leaflets | 4.79 ± 0.41 | 0.086 | 0.022 | 0.001 |
| 3.2.2 Health station, online live broadcast, and remote guidance | 4.36 ± 0.63 | 0.145 | 0.032 | 0.001 |
| 3.2.3 Observing, discussing, and researching issues related to community health care | 4.14 ± 0.86 | 0.209 | 0.072 | 0.002 |
| 3.2.4 Sinking village neighborhood committee to carry out nursing activities | 4.57 ± 0.65 | 0.141 | 0.015 | 0.000 |
| 4 Supporter for home care workers | 4.79 ± 0.43 | 0.089 | 0.132 | — |
| 4.1 Guide to master necessary and appropriate nursing techniques | 4.86 ± 0.36 | 0.075 | 0.045 | 0.006 |
| 4.1.1 To guide the improvement of a safe and appropriate medical care and rehabilitation environment at home | 4.71 ± 0.47 | 0.099 | 0.003 | 0.000 |
| 4.1.2 Guide home rehabilitation training | 4.79 ± 0.43 | 0.089 | 0.002 | 0.000 |
| 4.1.3 Guidance on home diet and medication | 4.71 ± 0.47 | 0.099 | 0.011 | 0.000 |
| 4.1.4 Guide the caregivers to master the rehabilitation nursing techniques of related diseases | 4.64 ± 0.50 | 0.107 | 0.004 | 0.000 |
| 4.1.5 Do a good job of health education for caregivers | 4.71 ± 0.47 | 0.099 | 0.007 | 0.000 |
| 4.1.6 First aid training for caregivers | 4.64 ± 0.50 | 0.107 | 0.004 | 0.000 |
| 4.1.7 Guide caregivers to master the content of disease surveillance | 4.57 ± 0.51 | 0.112 | 0.015 | 0.000 |
| 4.2 Provide psychological care and support to caregivers’ families | 4.79 ± 0.43 | 0.089 | 0.014 | 0.002 |
| 4.2.1 Give psychological support to the family members according to the evaluation results and guide the decompression. | 4.50 ± 0.65 | 0.145 | 0.011 | 0.000 |
| 4.2.2 Encourage caregivers and family members to talk about their nursing needs | 4.43 ± 0.85 | 0.192 | 0.003 | 0.000 |
| 4.3 Help to understand medical information and channels | 4.64 ± 0.63 | 0.136 | 0.072 | 0.010 |
| 4.3.1 Help to understand health policies, information and access to care | 4.50 ± 0.76 | 0.169 | 0.072 | 0.001 |
| 5. Collaborator of the family doctor team | 5.00 ± 0.00 | 0.000 | 0.142 | — |
| 5.1 Do a good job in health file management | 5.00 ± 0.00 | 0.000 | 0.070 | 0.010 |
| 5.1.1 Participate in the collection of health management information | 4.93 ± 0.27 | 0.054 | 0.037 | 0.000 |
| 5.1.2 Assist family doctors in contract work and health file management, and input of nursing follow-up information | 4.64 ± 0.63 | 0.136 | 0.023 | 0.000 |
| 5.1.3 Maintain health records and update information | 4.43 ± 0.76 | 0.171 | 0.010 | 0.000 |
| 5.2 Cooperate with family doctors | 4.86 ± 0.36 | 0.075 | 0.028 | 0.004 |
| 5.2.1 Cooperate with family doctors to follow up patients | 4.57 ± 0.65 | 0.141 | 0.006 | 0.000 |
| 5.2.2 Cooperate with all kinds of disease assessment | 4.50 ± 0.65 | 0.145 | 0.011 | 0.000 |
| 5.2.3 Do a good job of family doctor team publicity work | 4.21 ± 0.80 | 0.190 | 0.002 | 0.000 |
| 5.2.4 Cooperate with the establishment of family beds and do a good job in nursing | 4.43 ± 0.65 | 0.146 | 0.006 | 0.000 |
| 5.2.5 Assist family doctors to do two-way referral of patients | 4.21 ± 0.89 | 0.212 | 0.004 | 0.000 |
| 5.3 Do a good job in multi-dimensional and multi-dimensional coordination | 4.71 ± 0.47 | 0.099 | 0.044 | 0.006 |
| 5.3.1 Publicity and interpretation of family doctors’ contract related policies | 4.43 ± 0.76 | 0.171 | 0.023 | 0.000 |
| 5.3.2 Coordinating multidisciplinary teams and liaison with social resources | 4.43 ± 0.76 | 0.171 | 0.005 | 0.000 |
| 5.3.3 Participate in community diagnosis and health risk analysis | 4.14 ± 0.86 | 0.209 | 0.006 | 0.000 |
| 5.3.4 Contact and interact with neighborhood committees for joint management | 4.29 ± 0.61 | 0.143 | 0.011 | 0.000 |
| 6. Supervisor of home medical equipment use and medical waste disposal | 4.64 ± 0.50 | 0.107 | 0.157 | — |
| 6.1 Guide the standard use of point-of-care testing equipment (POCT) | 4.71 ± 0.47 | 0.099 | 0.118 | 0.019 |
| 6.1.1 Help patients and their families master the use, maintenance and maintenance of rapid testing equipment | 4.64 ± 0.50 | 0.107 | 0.118 | 0.002 |
| 6.2 Disposal of medical waste | 4.71 ± 0.47 | 0.099 | 0.039 | 0.006 |
| 6.2.1 Guide the classification, collection and disposal of medical waste | 4.64 ± 0.50 | 0.107 | 0.020 | 0.000 |
| 6.2.2 Prevention and emergency treatment of sharp weapon injuries | 4.57 ± 0.65 | 0.141 | 0.020 | 0.000 |
Note. Not applicable.