這是一篇指標(biāo)體系構(gòu)建的經(jīng)典文獻(xiàn)，值得各位老師去閱讀和學(xué)習(xí)。

以下是摘要部分

ABSTRACT

Background: The number of patients withdiabetes has been increasing rapidly according to a 2017 report by theInternational Diabetes Federation. Diabetes has become one of the mostchallenging public health problems, and there will be an estimated 143 millionpatients with diabetes in China by 2035. This puts considerable pressure onnurses who specialize in the care of patients with diabetes in China andincreases related social and financial burdens. Clinical practice has proventhat strengthening the core competencies of nurses and establishing anevaluation system of core competencies improve both healthcare quality andpatient quality of life. However, no core-competence system framework currentlyaddresses the unique characteristics of nurses in China.

背景：根據(jù)國際糖尿病聯(lián)合會(huì)2017年的一份報(bào)告，糖尿病患者的人數(shù)一直在迅速增加。糖尿病已經(jīng)成為最具挑戰(zhàn)性的公共衛(wèi)生問題之一，到2035年，中國估計(jì)將有1.43億糖尿病患者。這給專門從事中國糖尿病患者護(hù)理工作的護(hù)士帶來了巨大壓力，并增加了相關(guān)的社會(huì)和財(cái)務(wù)負(fù)擔(dān)。臨床實(shí)踐證明，加強(qiáng)護(hù)士的核心能力并建立核心能力評(píng)估系統(tǒng)可以改善醫(yī)療質(zhì)量和患者生活質(zhì)量。但是，目前還沒有核心競爭力系統(tǒng)框架能夠解決中國護(hù)士的獨(dú)特特征。

Purposes: The purpose of this study was toconstruct a core- competence system framework for primary nurse specialists indiabetes care.

目的：本研究的目的是為糖尿病護(hù)理的初級(jí)護(hù)士專家建立一個(gè)核心能力系統(tǒng)框架。

Methods: A brainstorming approach was conducted that worked to conceptualize the core competencies of nurse specialistsin diabetes care in China. Next, a study group organized this information andconducted a seminar; 50 experts and patients with diabetes were invited todevelop the first draft of the framework. Afterward, 50 experts were selected to participate in the Delphi survey. Most indicators were retained after athree-round Delphi process, and the superiority chart was used to determine theweights of the six dimensions.

方法：進(jìn)行了頭腦風(fēng)暴方法，以概念化中國糖尿病護(hù)理專業(yè)護(hù)士的核心能力。接下來，一個(gè)研究小組組織了這些信息并舉辦了一次研討會(huì)。邀請(qǐng)了50位糖尿病專家和患者來制定框架的初稿。之后，選擇了50名專家參加Delphi調(diào)查。經(jīng)過三輪Delphi處理后，大多數(shù)指標(biāo)得以保留，優(yōu)勢(shì)圖表用于確定這六個(gè)維度的權(quán)重。

Results: Forty-seven experts completed theconsultation. The experts' rate of response ranged from 94% to 100%, the authoritycoefficient was .91, and the Kendall's coefficients of concordance in Grades1–3 were .793, .418, and .542, respectively. An increasingly detailed,three-grade system framework was developed, including six first-gradeindicators (diabetes professional knowledge, diabetes-related knowledge,communication skills and health education ability, specialized skills, clinicaljudgment, and specialty development capacity), 23 second-grade indicators, and87 third-grade indicators. The weights of the six first-grade indicators were.221, .149, .192, .209, .160, and .069, respectively.

結(jié)果：47位專家完成了咨詢。專家的回應(yīng)率從94％到100％不等，權(quán)威系數(shù)為0.91，而1-3級(jí)的肯德爾一致性系數(shù)分別為0.793，0.418和0.542。開發(fā)了越來越詳細(xì)的三級(jí)系統(tǒng)框架，包括六個(gè)一級(jí)指標(biāo)（糖尿病專業(yè)知識(shí)，糖尿病相關(guān)知識(shí)，溝通技能和健康教育能力，專業(yè)技能，臨床判斷和專業(yè)發(fā)展能力），六個(gè)一級(jí)指標(biāo)的權(quán)重分別為0.221，0.149，0.192，0.209，0.160和0.069。二級(jí)指標(biāo)：23個(gè)指標(biāo)；三年級(jí)指標(biāo)：87個(gè)。

Conclusions: The core-competence systemframework includes six core competencies, which represent the main characteristicsof primary nurse specialists in diabetes care  who are highly recommendedby experts. It is important to keep in mind that this is only a theoreticalframework and thus must be further tested in clinical practice settings inChina.

結(jié)論：核心能力體系框架包括六個(gè)核心能力，這些代表了糖尿病專家的強(qiáng)烈推薦，代表了糖尿病護(hù)理初級(jí)護(hù)士的主要特征。重要的是要記住，這只是一個(gè)理論框架，因此必須在中國的臨床實(shí)踐環(huán)境中進(jìn)行進(jìn)一步的測(cè)試。

通過閱讀以上這篇文獻(xiàn)，讓我們回顧一下德爾菲法指標(biāo)體系構(gòu)建需要注意的事項(xiàng)：

1.需要有理論基礎(chǔ)，比如本文中是有明確的理論基礎(chǔ)的。

Theoretical basis：This study was based on the British “integrated career and competencyframework for diabetes nursing” model (Trend, 2011).Toaddresstheroleofnursespecialistsindiabetescare in China as educators,the framework referred to some rele- vant studies of the AADE(2011) and the Australian DiabetesEducators Association (2008). In addition, domestic nurses inemergencycare,peripherallyinsertedcentralcathetercare,intensivecareunits,andotherspecialties(Fan&Xi,2011;Yao, 2012) providedbasic information for thisstudy.

2、依照理論構(gòu)建自己研究的指標(biāo)框架

Development ofthe first draft of the framework

After the brainstorming phase, the Project ExecutionTeam organizedtheinformationandheldaseminartodetermine

the first draft of the corecompetence framework. The 50

participantsin this seminar included three diabetologists, 37nursespecialistsindiabetescare,fivenursingmanagers, and five patients withdiabetes.

3.招募咨詢專家，一般是30-50個(gè)專家，注意專家的專業(yè)性和權(quán)威性，還需要考慮專家的分布區(qū)域。

Expert panel selection and recruitment

Fifty diabetes experts from 28 provinces and municipalities joined the expert panel to (a) balance the differences amongregions and (b) maximize information diversity to make the framework moreuniversal and comprehensive. The experts included clinical diabetes nursespecialists, nursing managers, and diabetologists who had 10 years or more ofexperience in diabetes treatment and care.

4.Likert 評(píng)分方法是德爾菲專家咨詢法重要的評(píng)分方法

Data Collection

The Project Execution Team applied theDelphi method (Aljamal, Ashcroft, & Tully, 2016) to carry out three roundsof consultation between October 2015 and March 2016. In the first round,experts gave their advice on the first draft of the framework, with advicefocused mainly on the deletion, addition, or modification of indicators. In thesecond round, experts continued to provide new suggestions and assigned a valueto all of the indicators based on a 5-point Likert scale from 5 = very importantto 1 = not important. Afterward, group members readjusted and formed new indicatorsbased on the following screening criteria: mean > 3.5, coefficient ofvariation < 0.25, and expert approval rate > 70% (Guo, 2005; Wu, 2011).The third round  mirrored the process inthe second round and assigned weights to the first-grade indicators using thesuperiority chart (Cabral et al., 2005). All of the opinions were summarized toform the core competencies of primary nurse specialists in diabetes care.

6.數(shù)據(jù)結(jié)果統(tǒng)計(jì)中需要注意統(tǒng)計(jì)學(xué)方法的使用，比如專家一致性協(xié)調(diào)系數(shù)（-Kendall's coefficient of concordance (W)。專家的權(quán)威系數(shù)等。

Data Analysis

Microsoft Excel 2007 (Microsoft,Redmond, WA, USA) and IBM SPSS Statistics 17.0 software (SPSS, Inc., Chicago,IL, USA) were used to conduct data analysis and processing. Data were presentedas means and standard deviations for continuous variables. In general, theauthoritative coefficient (Cr) is composed on the basis of expert judgment (Ca)and of familiarity with the questions  (Cs).  The formula is  Cr = (Ca + Cs) / 2. The valueof Ca and Cs is obtained mainly through expert self-evaluation. The variablesCa and Cs reflect, respectively, the judgment and familiarity of the expertswith regard to survey content. Kendall's coefficient of concordance (W) refers to the level of intra expert agreement on all of the indicators. A nonparametrictest was applied for Kendall's coefficient of concordance (W).

7.專家咨詢需要有一輪，二輪專家咨詢技術(shù)路線圖

8.一級(jí)指標(biāo)，二級(jí)指標(biāo)，三級(jí)指標(biāo)需要有明確的結(jié)果呈現(xiàn)。

9.未完待續(xù)，敬請(qǐng)期待。

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