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

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

崔佳^{1, 2},
柴鑫¹,
叶丽红^{1, 2},
邵瑞太¹,
施小明²,
吕跃斌^2, ,,
张娟^1, ,

1.
中国医学科学院北京协和医学院群医学及公共卫生学院，北京 100730
2.
中国疾病预防控制中心环境与人群健康重点实验室，中国疾病预防控制中心环境与健康相关产品安全所，北京 100021

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
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- HTML全文浏览量: 70
- PDF下载量: 36
- 被引次数: 0
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

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

CUI Jia^{1, 2},
CHAI Xin¹,
YE Lihong^{1, 2},
SHAO Ruitai¹,
SHI Xiaoming²,
LYU Yuebin^{2
, ,},
ZHANG Juan^{1
, ,}

1.
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2.
China Center for Disease Control and Prevention Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China

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

Corresponding author: LYU Yuebin, E-mail: lvyuebin@nieh.chinacdc.cn; ZHANG Juan, E-mail: zhangjuan@sph.pumc.edu.cn

摘要

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。
- 健康问题 /
- 老年人 /
- 德尔菲法 /
- 专家共识
Abstract: Objective To explore important health problems for Chinese older adults based on the Delphi method. Methods A list of important health problems for Chinese older adults was identified through literature search and expert discussion. Using the Delphi method, 25 experts from various disciplines were invited from August to December 2022. Consultation questionnaires were distributed by email, and expert were asked to select the most important health problems, and assess the importance, controllability, familiarity for each health problems. Active coefficient, selection rate, importance score, controllability score and composite index were analyzed to identify the important health problems for Chinese older adults. Results The active coefficients in two rounds expert consultation were 96.00% (24/25) and 79.17% (19/24), respectively. Considering the expert selection rate, importance, controllability and composite index, five important health problems were identified, including disability of activities of daily life, falls, cognitive impairment, depression, and stroke. Conclusions Through two rounds of Delphi consultation, five important health problems for Chinese older adults were identified, which have certain guiding significance for establishing priorities for health problems of the elderly and formulating relevant health policies in China.
- Health problem /
- Aged /
- Delphi method /
- Expert consensus

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表 1 专家基本情况

Table 1. Basic characteristics of the experts

特征Characteristic	第1轮咨询 ^⑤ First round consultation ^⑤ (n=24)	第2轮咨询 ^⑤ Second round consultation ^⑤ (n=19)	χ²/H值value	P值value
年龄/岁 ^① Age/years ^①	48.71±8.62	47.84±8.85	0.323	0.748
性别 ^② Gender ^②			0.228	0.633
男Male	6(25.00)	6(31.58)
女Female	18(75.00)	13(68.42)
最高学历 ^③ Highest degree ^③			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 ^③ Title ^③			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 ^④ Work unit ^④			-	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 ^③ Work experience ^③			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.

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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
健康问题Health problem	框架Framework	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.

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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
健康问题Health problem	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.

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特征Characteristic	第1轮咨询 ^⑤ First round consultation ^⑤ (n=24)	第2轮咨询 ^⑤ Second round consultation ^⑤ (n=19)	χ²/H值value	P值value
年龄/岁 ^① Age/years ^①	48.71±8.62	47.84±8.85	0.323	0.748
性别 ^② Gender ^②			0.228	0.633
男Male	6(25.00)	6(31.58)
女Female	18(75.00)	13(68.42)
最高学历 ^③ Highest degree ^③			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 ^③ Title ^③			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 ^④ Work unit ^④			-	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 ^③ Work experience ^③			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.

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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

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

吕跃斌，E-mail：lvyuebin@nieh.chinacdc.cn

计量

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

Corresponding author: LYU Yuebin, E-mail: lvyuebin@nieh.chinacdc.cn; ZHANG Juan, E-mail: zhangjuan@sph.pumc.edu.cn

计量

目录

留言板

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

通讯作者: 张娟，E-mail：zhangjuan@sph.pumc.edu.cn 吕跃斌，E-mail：lvyuebin@nieh.chinacdc.cn

计量

出版历程

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

Corresponding author: LYU Yuebin, E-mail: lvyuebin@nieh.chinacdc.cn; ZHANG Juan, E-mail: zhangjuan@sph.pumc.edu.cn

计量

出版历程

目录

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

吕跃斌，E-mail：lvyuebin@nieh.chinacdc.cn