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[目的]建立客观评价《职业健康监护技术规范》(GBZ 188—2007)应用情况的方法。[方法]应用改良德尔菲法(Delphi method),建立“规范”评价的指标体系,确立各级指标权重值,根据指标体系编制调查问卷,对我国大陆地区主要省、市、县级疾病预防控制中心,职业病防治院(所),综合性医院,其他职业健康监护机构主要负责人及主检人员进行问卷调查。对调查结果进行模糊评分,结合各指标权重值,应用模糊综合评价方法对“规范”进行等级评价。[结果]我国大陆地区该领域17名专家参与了评价指标体系构建的两轮咨询,专家权威系数为0.904,指标总体协调系数为0.469(P<0.01)。评价指标体系由3个一级指标、14个二级指标和70个三级指标构成,涵盖规范实施情况、科学内涵及实施绩效评价内容。114位被调查者参与问卷调查,问卷回收率100%。规范总体模糊综合评价为“优”、“中”、“差”的比例分别为80.8%、14.7%、4.5%。其中,实施情况、实施绩效、内涵评估分项评价结果中为“优”者的比例分别为78.4%、75.1%、83.0%。[结论]改良德尔菲法与模糊综合评价法有机结合,可有效解决客观评价规范、标准应用情况的难题。本方法应用价值尚有待于进一步证实。
[Objective] To establish a method for objectively evaluating the application of Technical Specifications for Occupational Health Monitoring (GBZ 188-2007). [Methods] The Delphi method was used to establish the index system of “standard” evaluation, establish the weight value of indicators at all levels, and prepare the questionnaire according to the index system to assess the risk of major diseases in major provinces, cities and counties in mainland China Prevention and Control Center, occupational disease prevention and cure hospital (the), general hospitals, other occupational health monitoring agencies and the main seizure of key personnel survey. The results of the fuzzy evaluation of the score, combined with the weight of each index, the application of fuzzy comprehensive evaluation of the “standard” for the level of evaluation. [Results] Seventeen experts in this field of mainland China participated in the two rounds of consulting for the construction of the evaluation index system. The coefficient of expert authority was 0.904, and the overall coordination coefficient of the index was 0.469 (P <0.01). The evaluation index system consists of three first-level indicators, 14 second-level indicators and 70 third-level indicators, covering the implementation of the code, the scientific content and the implementation of performance evaluation. 114 respondents participated in the questionnaire survey, the questionnaire recovery rate of 100%. The overall fuzzy comprehensive evaluation of the norms is 80.8%, 14.7% and 4.5%, respectively, for “excellent”, “medium” and “bad”. Among them, the proportions of “excellent” persons in implementation, performance and connotation evaluation were 78.4%, 75.1% and 83.0% respectively. [Conclusion] The improved Delphi method combined with fuzzy comprehensive evaluation method can effectively solve the problems of objective evaluation standard and standard application. The value of this method has yet to be further confirmed.