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基于德尔菲法探索中国老年人的重要健康问题

崔佳 柴鑫 叶丽红 邵瑞太 施小明 吕跃斌 张娟

崔佳, 柴鑫, 叶丽红, 邵瑞太, 施小明, 吕跃斌, 张娟. 基于德尔菲法探索中国老年人的重要健康问题[J]. 中华疾病控制杂志, 2024, 28(3): 361-367. doi: 10.16462/j.cnki.zhjbkz.2024.03.019
引用本文: 崔佳, 柴鑫, 叶丽红, 邵瑞太, 施小明, 吕跃斌, 张娟. 基于德尔菲法探索中国老年人的重要健康问题[J]. 中华疾病控制杂志, 2024, 28(3): 361-367. doi: 10.16462/j.cnki.zhjbkz.2024.03.019
CUI Jia, CHAI Xin, YE Lihong, SHAO Ruitai, SHI Xiaoming, LYU Yuebin, ZHANG Juan. Exploring important health problems for Chinese older adults based on Delphi method[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(3): 361-367. doi: 10.16462/j.cnki.zhjbkz.2024.03.019
Citation: CUI Jia, CHAI Xin, YE Lihong, SHAO Ruitai, SHI Xiaoming, LYU Yuebin, ZHANG Juan. Exploring important health problems for Chinese older adults based on Delphi method[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(3): 361-367. doi: 10.16462/j.cnki.zhjbkz.2024.03.019

基于德尔菲法探索中国老年人的重要健康问题

doi: 10.16462/j.cnki.zhjbkz.2024.03.019
基金项目: 

慢性病群医学基地建设 WH10022022010

国家自然科学基金 82230111

国家自然科学基金 82025030

国家自然科学基金 82222063

详细信息
    通讯作者:

    张娟,E-mail:zhangjuan@sph.pumc.edu.cn

    吕跃斌,E-mail:lvyuebin@nieh.chinacdc.cn

  • 中图分类号: R181

Exploring important health problems for Chinese older adults based on Delphi method

Funds: 

Disciplines Construction Project: Population Medicine WH10022022010

National Natural Science Foundation of China 82230111

National Natural Science Foundation of China 82025030

National Natural Science Foundation of China 82222063

More Information
  • 摘要:   目的  基于德尔菲法探索中国老年人的重要健康问题。  方法  通过文献检索和专家讨论, 制定老年人健康问题的条目清单。采用德尔菲法, 于2022年8―12月邀请25名来自不同领域的专家, 通过邮件发放咨询问卷, 要求专家选择出最重要的健康问题并逐个对健康问题的重要性、可控制性及熟悉程度进行评分。分析专家的积极程度、选择率、重要性得分、可控制性得分及综合指数, 最终确定中国老年人的重要健康问题。  结果  2轮专家咨询的专家积极系数分别为96.00%(24/25)和79.17%(19/24)。综合考虑专家选择率、重要性、可控制性及综合指数, 最终确定活动能力受损、跌倒、认知障碍、抑郁症和脑卒中为我国老年人的重要健康问题。  结论  通过2轮德尔菲法, 共识别出我国老年人的5个重要健康问题, 对我国建立老年人健康问题优先事项、制定相关卫生政策具有一定的指导意义。
  • 表  1  专家基本情况

    Table  1.   Basic characteristics of the experts

    特征Characteristic 第1轮咨询
    First round consultation
    (n=24)
    第2轮咨询
    Second round consultation
    (n=19)
    χ2/H值value P值value
    年龄/岁 Age/years 48.71±8.62 47.84±8.85 0.323 0.748
    性别 Gender 0.228 0.633
      男Male 6(25.00) 6(31.58)
      女Female 18(75.00) 13(68.42)
    最高学历 Highest degree 0.221 0.638
      大学本科Undergraduate degree 1(4.16) 0(0)
      硕士研究生Master degree 4(16.67) 3(15.79)
      博士研究生Doctoral degree 19(79.17) 16(84.21)
    职称 Title 0.134 0.714
      中级Middle 1(4.17) 0(0)
      副高级Vice-senior 5(20.83) 5(26.32)
      正高级Senior 18(75.00) 14(73.68)
    工作单位 Work unit - 0.945
      卫生行政部门Health administrative department 1(4.17) 1(5.26)
      疾病控制部门Disease control department 2(8.33) 2(10.53)
      高等院校Institutions of higher learning 5(20.83) 5(26.32)
      医疗机构Medical organization 16(66.67) 11(57.89)
    工作年限 Work experience 0.210 0.646
       < 10年years 3(12.50) 3(15.79)
      10~19年years 8(33.33) 7(36.84)
      ≥20年years 13(54.17) 9(47.37)
    注:① 2轮咨询中专家年龄均符合正态分布,采用t检验比较2轮专家年龄差异;②采用χ2检验;③采用Kruskal-Wallis检验;④采用Fisher′s确切概率法,无统计值;⑤以人数(占比/%)或x ±s表示。
    Note: ① The distribution of experts′ age in two rounds were normal distribution, and t test were used to compare the differences;②χ2 test;③ Kruskal-Wallis test;④ Fisher′s exact test, with no statistical values;⑤Number of people(proportion/%) or x ±s.
    下载: 导出CSV

    表  2  健康问题选择率

    Table  2.   The selection rate of health problems

    健康问题Health problem 框架Framework 第1轮选择率First round selection rate 第2轮选择率Second round selection rate
    人数(占比/%)Number of people(proportion/%) 排名Rank 人数(占比/%)Number of people(proportion/%) 排名Rank
    活动能力受损Impaired mobility A 24(100.00) 1 19(100.00) 1
    认知受损Cognitive impairment A 24(100.00) 1 19(100.00) 1
    抑郁症Depressive disorder B 20(83.33) 3 15(78.95) 3
    跌倒Fall E 16(66.67) 5 15(78.95) 3
    脑卒中Stoke C 14(58.33) 7 11(57.89) 5
    视力障碍Visual impairment A 19(79.17) 4 9(47.37) 6
    肿瘤Tumor C 10(41.67) 9 9(47.37) 6
    急性心肌梗死Acute myocardial infarction C 9(37.50) 10 8(42.11) 8
    共病Comorbidity E 9(37.50) 10 8(42.11) 8
    帕金森病Parkinson′s disease C 8(42.11) 8
    营养不良Malnutrition E 7(36.84) 11
    听力损失Hearing loss A 15(62.50) 6 6(31.58) 12
    慢性疼痛Chronic pain C 12(50.00) 8 6(31.58) 12
    尿失禁Uracratia A 9(37.50) 10 4(21.05) 14
    睡眠障碍Somnipathy E 8(33.33) 13 4(21.05) 14
    新发传染病(如COVID-19) Emerging infectious diseases (such as COVID-19) D 5(20.83) 15 3(15.79) 16
    糖尿病Diabetes C 3(12.50) 19 3(15.79) 16
    高血压Hypertension C 1(4.17) 21 2(10.53) 18
    慢性阻塞性肺疾病Chronic obstructive pulmonary disease C 4(16.67) 17 2(10.53) 18
    冠状动脉粥样硬化性心脏病Coronary atherosclerotic heart disease C 6(25.00) 14 1(5.26) 20
    口腔疾病Oral disease C 5(20.83) 15 1(5.26) 20
    肺炎球菌性疾病Pneumococcal diseases D 2(8.33) 20 1(5.26) 20
    带状疱疹Shingles D 4(16.67) 17 0(0) 23
    流行性感冒Influenza D 0(0) 22 0(0) 23
    睡眠呼吸暂停综合征Sleep apnea syndrome E 0(0) 22
    注:A,功能问题;B,心理问题;C,非传染性疾病;D,传染性疾病;E,其他健康问题。
    Note: A, functional problems; B, psychological problems; C, non-communicable diseases;D, communicable diseases;E, other health problems.
    下载: 导出CSV

    表  3  健康问题重要性、可控制性及综合指数加权得分

    Table  3.   Importance score, controllability score and composite index of health problems

    健康问题Health problem 重要性得分Importance score 可控制性得分Controllability score 综合指数composite index
    x±s 排名Rank x±s 排名Rank M(P25, P75) 排名Rank
    跌倒Fall 7.79±1.49 2 6.90±1.43 2 0.84 (0.59, 0.94) 1
    活动能力受损Impaired mobility 7.89±1.23 1 6.25±1.29 5 0.79 (0.69, 0.89) 2
    认知受损Cognitive impairment 7.63±1.26 3 5.66±1.68 12 0.73 (0.60, 0.89) 3
    抑郁症Depressive disorder 6.94±1.51 6 5.60±1.63 13 0.65 (0.43, 0.79) 4
    脑卒中Stoke 7.15±1.80 4 6.06±1.92 6 0.52 (0.00, 0.78) 5
    营养不良Malnutrition 7.11±1.88 5 7.04±1.59 1 0.00 (0.00, 1.00) 6
    共病Comorbidity 6.47±1.80 10 5.42±1.80 17 0.00 (0.00, 0.74) 6
    急性心肌梗死Acute myocardial infarction 6.56±2.09 7 5.57±2.06 14 0.00 (0.00, 0.61) 6
    视力障碍Visual impairment 6.04±1.78 16 4.99±1.88 21 0.00 (0.00, 0.60) 6
    肿瘤Tumor 5.60±2.12 22 4.12±2.22 24 0.00 (0.00, 0.56) 6
    帕金森病Parkinson's disease 6.11±2.04 15 4.37±2.03 23 0.00 (0.00, 0.56) 6
    慢性疼痛Chronic pain 6.25±1.73 13 5.46±1.72 16 0.00 (0.00, 0.56) 6
    听力损失Hearing loss 5.89±1.88 18 5.14±2.14 20 0.00 (0.00, 0.52) 6
    睡眠障碍Somnipathy 6.50±1.75 9 5.88±1.58 10 0.00 (0.00, 0.00) 6
    新发传染病(如COVID-19) Emerging infectious diseases (such as COVID-19) 6.29±1.78 12 5.51±2.11 15 0.00 (0.00, 0.00) 6
    尿失禁Uracratia 5.67±1.74 21 4.68±1.81 22 0.00 (0.00, 0.00) 6
    糖尿病Diabetes 6.39±1.40 11 6.43±1.75 4 0.00 (0.00, 0.00) 6
    高血压Hypertension 6.23±1.70 14 6.76±1.58 3 0.00 (0.00, 0.00) 6
    慢性阻塞性肺疾病Chronic obstructive pulmonary disease 5.90±1.80 17 5.19±1.66 19 0.00 (0.00, 0.00) 6
    肺炎球菌性疾病Pneumococcal diseases 5.73±2.21 20 5.75±2.26 11 0.00 (0.00, 0.00) 6
    口腔疾病Oral disease 5.49±1.72 23 5.29±1.81 18 0.00 (0.00, 0.00) 6
    冠状动脉粥样硬化性心脏病Coronary atherosclerotic heart disease 6.51±1.84 8 6.05±2.11 8 0.00 (0.00, 0.00) 6
    流行性感冒Influenza 5.79±1.90 19 6.06±1.94 6 0.00 (0.00, 0.00) 6
    带状疱疹Shingles 5.43±1.77 24 6.01±1.91 9 0.00 (0.00, 0.00) 6
    注:重要性得分、可控制性得分及综合指数均经熟悉程度加权,加权系数为熟悉程度得分/9。
    Note: The importance score, controllability score and composite index were weighted by familiarity, and the weighting coefficient was familiarity score/9.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-08-04
  • 修回日期:  2024-01-06
  • 网络出版日期:  2024-04-08
  • 刊出日期:  2024-03-10

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