基于德尔菲法初步编制门诊慢性病患者参与用药安全能力自评量表

Background Patient medication safety has become a global priority in healthcareand patients play an important role in promoting their own medication safety. Objective To develop a self-assessment scale for the ability of outpatients with chronic diseases to participate in medication safety based on the Delphi method and provide objective criteria for assessing and promoting their abilities to participate in medication safety. Methods A literature review and semi-structured interviews were used to formulate the initial entries of scale for the ability of outpatients with chronic diseases to participate in medication safety. According to the study objectives28 experts from BeijingShanghaiGuangdongTianjinZhejiang and Inner Mongolia participated in two rounds of correspondence using the Delphi methodand were asked to rate their familiarity and judgement basis of the dimensionsand the importance and feasibility of the items were rated using a fivepoint Likert scale. The first round of expert correspondence was conducted from 30 September to 12 October 2021and the second round was conducted from 5 to 15 November 2021. Final items of the scale were determined through an expert panel discussion. The questionnaire recovery rate was calculated as a reflection of expert motivationthe degree of authority of the correspondence results was measured using the authority coefficientthe degree of coordination of expert opinions was evaluated using the coefficient of variation and the coordination coefficient Kendall's W. The arithmetic mean of importance and feasibility scores ≥ 3.5 and coefficient of variation<0.25 were used as the initial reference for items selectionthe adjustments of the items were decided after the thorough discussions among the members of research team and the expert panel combining with the opinions of experts. Results In both rounds of correspondence28 questionnaires were sent out and 28 questionnaires were returnedwith a positive coefficient of 100% and the expert authority coefficient of 0.877. The expert coordination coefficient Kendall's W of the importance and the feasibility of items in the second round of correspondence increased compared to the first round of correspondence. The mean importance scores of items in the two rounds of the consultation ranged from 3.964 to 4.964 and 4.321 to 5.000with coefficients of variation from 0.038 to 0.211 and 0 to 0.168. The mean feasibility scores of the items in the two rounds of the consultation ranged from 3.964 to 4.821 and 4.036 to 4.893with coefficients of variation from 0.081 to 0.265 and 0.064 to 0.186respectively. The final self-assessment scale for the ability of outpatients with chronic diseases to participate in medication safety was determined after two rounds of expert correspondence and an expert panel discussionincluding 4 dimensions of medication knowledgemedication beliefparticipation in medication decision-makingand medication self-managementwith 33 items. Conclusion A self-assessment scale for the ability of outpatients with chronic diseases to participate in medication safety containing four dimensions of medication knowledgemedication beliefparticipation in medication decision-making and medication self-managementwith 33 itemswas constructed in the studywhich can assess the ability of outpatients with chronic diseases to participate in medication safety and provide a reference for developing appropriate measures to promote patient participation in the medication process and improve medication safety.