Construction of a sensitive quality indicator system for ambulatory chemotherapy nursing based on the structure-process-outcome model_West China Medical Journal

Authors：

LI Shuo ¹ , JIN Xiaoyan ² ,  GAO Fengli ¹

1. Department of Nursing, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, P. R. China;
2. Peking University Health Science Center-Macao Polytechnic University Nursing Academy, Macao Polytechnic University, Macao 999078, P. R. China;

Corresponding?author：

GAO Fengli, Email: gfla00059@btch.edu.cn

Keywords：

Ambulatory chemotherapy; sensitive quality indicator for nursing; Delphi method

DOI：

10.7507/1002-0179.202406011

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To construct a sensitive indicator system for the quality of ambulatory chemotherapy nursing, and provide reference basis for the evaluation and scientific management of ambulatory chemotherapy nursing quality. Method Based on Donabedian’s three-dimensional quality structure model of “structure process result”, through literature review, a preliminary quality indicator system for ambulatory chemotherapy nursing was formulated. The Delphi method was used for two rounds of expert inquiry to determine the sensitive treatment indicator system for ambulatory chemotherapy nursing. The weight of the indicators was calculated using the hierarchical analysis method. Result Fifteen expert inquiry questionnaires were distributed through two rounds of inquiry, and the response rates of the two rounds of expert inquiry questionnaires were all 100%, with expert positivity coefficients of 100% and authority coefficients of 0.90 and 0.94, respectively. The second round of expert inquiry questionnaires Kendall’s coefficient of concordance were between 0.573 and 0.769 (P<0.01). The final constructed quality sensitive indicator system for ambulatory chemotherapy nursing included 3 primary indicators, 8 secondary indicators, and 27 tertiary indicators. The overall Cronbach’s α coefficient for the second round of inquiry questionnaires was 0.853, while the Cronbach’s α coefficients for structural indicators, process indicators, and outcome indicators were 0.879, 0.921, and 0.857, respectively. Conclusions The sensitive indicator system for nursing quality in ambulatory chemotherapy wards constructed has high systematicity, sensitivity, and scientificity, and the weight distribution is reasonable. This indicator system can provide a reference basis for objective evaluation and standardized management of nursing quality in ambulatory chemotherapy.

Citation： LI Shuo, JIN Xiaoyan, GAO Fengli. Construction of a sensitive quality indicator system for ambulatory chemotherapy nursing based on the structure-process-outcome model. West China Medical Journal, 2025, 40(2): 261-268. doi: 10.7507/1002-0179.202406011 Copy

1.	湯磊雯, 葉志弘, 潘紅英. 護理質量敏感指標體系的構建與實施. 中華護理雜志, 2013, 48(9): 801-803.
2.	蘇亞平, 李瑞玲, 王園園, 等. 老年髖關節置換病人護理敏感質量指標體系的構建. 護理研究, 2023, 37(24): 4378-4385.
3.	李黎, 郭驪莉. 專科護理敏感質量指標對于改善肝癌介入術后尿潴留患者的應用價值. 介入放射學雜志, 2022, 31(6): 613-615.
4.	李夢奇, 孫蓓, 汪洋, 等. 日間化學治療模式下醫護人員對靜脈治療護士主導的血管通路共享決策認知與體驗的質性研究. 華西醫學, 2024, 39(2): 234-239.
5.	汪洋, 孫蓓, 李夢奇, 等. 基于瑞士奶酪模型的護理管理模式在日間病房化學治療患者安全用藥中的應用. 華西醫學, 2024, 39(2): 229-233.
6.	孫蓓, 汪洋, 孫英明, 等. 按病種分值付費背景下乳腺癌日間化療患者經濟毒性預警模型的構建. 華西醫學, 2023, 38(2): 226-232.
7.	張雨晨, 戴燕, 宋應寒. 日間手術護理質量敏感指標體系的構建. 華西醫學, 2021, 36(2): 220-224.
8.	周芬, 郝玉芳, 叢雪, 等. 指南研究與評價工具 AGREE Ⅱ及各領域分值的補充解釋及思考. 護理學報, 2018, 25(18): 56-58.
9.	李晨雄, 王丹, 莫陶欣, 等. 國內日間化療工作開展現況調查研究. 中國醫院管理, 2022, 42(2): 47-49.
10.	Powell C. The Delphi technique: myths and realities. J Adv Nurs, 2003, 41(4): 376-382.
11.	伍琳, 孫艷杰. 德爾菲法簡介及在護理學中的應用現狀. 護理研究, 2015, 29(29): 3599-3601.
12.	余茴香, 劉櫻, 胡保紅, 等. 基于三維質量模式構建圍術期癌癥病人營養護理質量評價指標體系. 護理研究, 2022, 36(3): 386-392.
13.	Kaymaz ?K, Birinci S, K?z?lkan Y. Sustainable development goals assessment of Erzurum province with SWOT-AHP analysis. Environ Dev Sustain, 2022, 24(3): 2986-3012.
14.	黃天雯, 張偉玲, 劉圓圓, 等. 基于敏感指標的骨科專科護理質量標準的構建. 護理研究, 2022, 36(4): 580-586.
15.	關勛強, 李瑞興, 劉運成. 醫學研究生教育評價研究與實踐. 北京: 軍事醫學科學出版社, 2001: 80-84.
16.	張先庚, 劉珊, 劉林峰, 等. 基于德爾菲法構建初級醫養結合老年護理人才崗位勝任力評價指標體系. 解放軍護理雜志, 2022, 39(3): 24-27.
17.	Prip A, M?ller KA, Nielsen DL, et al. The patient-healthcare professional relationship and communication in the oncology outpatient setting: a systematic review. Cancer Nurs, 2018, 41(5): E11-E22.
18.	Arbour C, Tremblay M, Ogez D, et al. Feasibility and acceptability of hypnosis-derived communication administered by trained nurses to improve patient well-being during outpatient chemotherapy: a pilot-controlled trial. Support Care Cancer, 2022, 30(1): 765-773.
19.	林夢, 馬晶晶, 陳秋蓉, 等. 血液腫瘤患兒專科護理質量敏感指標體系的構建. 中華現代護理雜志, 2022, 28(6): 782-787.
20.	蘭嵐, 楊丹, 劉君, 等. 急性心肌梗死護理質量敏感性指標的研究進展. 護理研究, 2022, 36(5): 880-883.
21.	Singh K, Kober KM, Paul SM, et al. Gastrointestinal symptoms are associated with trajectories of chemotherapy-induced nausea. Support Care Cancer, 2020, 28(5): 2205-2215.
22.	Sonneborn-Papakostopoulos M, Dubois C, Mathies V, et al. Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: a cross-sectional study. Med Oncol, 2021, 38(2): 20.
23.	Saragiotto L, Leandro-Merhi VA, Aquino JLB, et al. Gastrointestinal changes during nutritional follow-up of cancer patients undergoing outpatient chemotherapy. Arq Gastroenterol, 2020, 57(4): 354-360.
24.	Huang YL, Bryce AH, Culbertson T, et al. Alternative outpatient chemotherapy scheduling method to improve patient service quality and nurse satisfaction. J Oncol Pract, 2018, 14(2): e82-e91.
25.	Krzyzanowska MK, Julian JA, Gu CS, et al. Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trial. BMJ, 2021, 375: e066588.
26.	朱紅, 劉爭, 王埡, 等. 基于三維質量評價模式構建住院患者非計劃拔管風險管理質量評價體系. 護理學報, 2022, 29(1): 7-12.
27.	潘世琴, 羅明琴, 趙生秀, 等. 基于層次分析法構建青海省三級醫院護理質量評價指標體系. 護理管理雜志, 2023, 23(12): 951-955.
28.	連潔, 高漢, 楊雪, 等. 門診化療一體化管理模式的建立. 中國衛生標準管理, 2023, 14(15): 44-48.

1. 湯磊雯, 葉志弘, 潘紅英. 護理質量敏感指標體系的構建與實施. 中華護理雜志, 2013, 48(9): 801-803.
2. 蘇亞平, 李瑞玲, 王園園, 等. 老年髖關節置換病人護理敏感質量指標體系的構建. 護理研究, 2023, 37(24): 4378-4385.
3. 李黎, 郭驪莉. 專科護理敏感質量指標對于改善肝癌介入術后尿潴留患者的應用價值. 介入放射學雜志, 2022, 31(6): 613-615.
4. 李夢奇, 孫蓓, 汪洋, 等. 日間化學治療模式下醫護人員對靜脈治療護士主導的血管通路共享決策認知與體驗的質性研究. 華西醫學, 2024, 39(2): 234-239.
5. 汪洋, 孫蓓, 李夢奇, 等. 基于瑞士奶酪模型的護理管理模式在日間病房化學治療患者安全用藥中的應用. 華西醫學, 2024, 39(2): 229-233.
6. 孫蓓, 汪洋, 孫英明, 等. 按病種分值付費背景下乳腺癌日間化療患者經濟毒性預警模型的構建. 華西醫學, 2023, 38(2): 226-232.
7. 張雨晨, 戴燕, 宋應寒. 日間手術護理質量敏感指標體系的構建. 華西醫學, 2021, 36(2): 220-224.
8. 周芬, 郝玉芳, 叢雪, 等. 指南研究與評價工具 AGREE Ⅱ及各領域分值的補充解釋及思考. 護理學報, 2018, 25(18): 56-58.
9. 李晨雄, 王丹, 莫陶欣, 等. 國內日間化療工作開展現況調查研究. 中國醫院管理, 2022, 42(2): 47-49.
10. Powell C. The Delphi technique: myths and realities. J Adv Nurs, 2003, 41(4): 376-382.
11. 伍琳, 孫艷杰. 德爾菲法簡介及在護理學中的應用現狀. 護理研究, 2015, 29(29): 3599-3601.
12. 余茴香, 劉櫻, 胡保紅, 等. 基于三維質量模式構建圍術期癌癥病人營養護理質量評價指標體系. 護理研究, 2022, 36(3): 386-392.
13. Kaymaz ?K, Birinci S, K?z?lkan Y. Sustainable development goals assessment of Erzurum province with SWOT-AHP analysis. Environ Dev Sustain, 2022, 24(3): 2986-3012.
14. 黃天雯, 張偉玲, 劉圓圓, 等. 基于敏感指標的骨科專科護理質量標準的構建. 護理研究, 2022, 36(4): 580-586.
15. 關勛強, 李瑞興, 劉運成. 醫學研究生教育評價研究與實踐. 北京: 軍事醫學科學出版社, 2001: 80-84.
16. 張先庚, 劉珊, 劉林峰, 等. 基于德爾菲法構建初級醫養結合老年護理人才崗位勝任力評價指標體系. 解放軍護理雜志, 2022, 39(3): 24-27.
17. Prip A, M?ller KA, Nielsen DL, et al. The patient-healthcare professional relationship and communication in the oncology outpatient setting: a systematic review. Cancer Nurs, 2018, 41(5): E11-E22.
18. Arbour C, Tremblay M, Ogez D, et al. Feasibility and acceptability of hypnosis-derived communication administered by trained nurses to improve patient well-being during outpatient chemotherapy: a pilot-controlled trial. Support Care Cancer, 2022, 30(1): 765-773.
19. 林夢, 馬晶晶, 陳秋蓉, 等. 血液腫瘤患兒專科護理質量敏感指標體系的構建. 中華現代護理雜志, 2022, 28(6): 782-787.
20. 蘭嵐, 楊丹, 劉君, 等. 急性心肌梗死護理質量敏感性指標的研究進展. 護理研究, 2022, 36(5): 880-883.
21. Singh K, Kober KM, Paul SM, et al. Gastrointestinal symptoms are associated with trajectories of chemotherapy-induced nausea. Support Care Cancer, 2020, 28(5): 2205-2215.
22. Sonneborn-Papakostopoulos M, Dubois C, Mathies V, et al. Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: a cross-sectional study. Med Oncol, 2021, 38(2): 20.
23. Saragiotto L, Leandro-Merhi VA, Aquino JLB, et al. Gastrointestinal changes during nutritional follow-up of cancer patients undergoing outpatient chemotherapy. Arq Gastroenterol, 2020, 57(4): 354-360.
24. Huang YL, Bryce AH, Culbertson T, et al. Alternative outpatient chemotherapy scheduling method to improve patient service quality and nurse satisfaction. J Oncol Pract, 2018, 14(2): e82-e91.
25. Krzyzanowska MK, Julian JA, Gu CS, et al. Remote, proactive, telephone based management of toxicity in outpatients during adjuvant or neoadjuvant chemotherapy for early stage breast cancer: pragmatic, cluster randomised trial. BMJ, 2021, 375: e066588.
26. 朱紅, 劉爭, 王埡, 等. 基于三維質量評價模式構建住院患者非計劃拔管風險管理質量評價體系. 護理學報, 2022, 29(1): 7-12.
27. 潘世琴, 羅明琴, 趙生秀, 等. 基于層次分析法構建青海省三級醫院護理質量評價指標體系. 護理管理雜志, 2023, 23(12): 951-955.
28. 連潔, 高漢, 楊雪, 等. 門診化療一體化管理模式的建立. 中國衛生標準管理, 2023, 14(15): 44-48.

West China Medical Journal

Construction of a sensitive quality indicator system for ambulatory chemotherapy nursing based on the structure-process-outcome model

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content