Abstract: Background　Most of the health education recommendations from Chinese guidelines ignore the characteristics and patient needs of primary health care，especially type 2 diabetes mellitus（T2DM） health education delivered by primary outpatient clinics is random，untargeted and so on. Objective　To develop a primary care needs-based health education services framework for T2DM patients using the nominal group technique（NGT），and to expand its essentials. Methods　From September to October 2020，NGT was used to conduct meetings in three groups of Chinese health professionals（n=23） in various medical specialties selected using purposive sampling. The results of meetings were recorded and transcribed，and divided into qualitative and quantitative data for analyses. After merging the similar ones of keywords of qualitative data of each group discussion，the list of network coded（NC） keywords was obtained，and essential contents of these key words were expanded，and analyzed using thematic analysis. Intra-group and overall ranking of keywords of the quantitative data in the list were determined. Finally，the hierarchical frameworkwas determined according to the quartile assigned by the overall ranking. Results　Twenty-eight keywords regarding T2DM health education were obtained through group discussions and decision-making，and classified into five themes by thematic analysis and content development：diabetes-related knowledge，self-management，community management，multiple comorbidities management，treatment and medication. After two rounds of ranking and stratification，a four-level hierarchical framework of health education for T2DM patients was finally determined. The A hierarchy includes four top-ranked keywords，accounting for 45.69% of the total mean rank scores. Conclusion　We applied NGT to develop a primary care needs-based health education services guiding framework for Chinese T2DM patients，and used an evidence-based approach to determine its four-level hierarchy and highlighted contents. As patients' primary care needs are complex，which need to be satisfied based on group decision-making，our framework may contribute to achieve a higher consistency between guidelines and clinical practice.

Key words: Diabetes mellitus, type 2；Health education；Primary health care；Community health services；Nominal group technique；Evidence-based medicine

摘要： 背景　我国大部分指南的健康教育建议忽视初级保健特征及需求，基层门诊2型糖尿病（T2DM）健康教育存在随意、盲目等诸多问题。目的　应用名义小组技术（NGT）构建基于初级保健服务需求的T2DM患者健康教育框架，并进行内涵拓展。方法　于2020年9—10月，采用目的性抽样的方法，邀请国内具有不同医学背景的健康专业人员23例，分为3个小组开展NGT会议。对会议内容汇总、转录，产生定性与定量两部分数据，并行分析。通过定性数据对各组产生的关键词进行合并相似词等处理，以获得重编码关键词（NC）列表，同时对关键词进行内涵拓展和主题分析；定量数据确定关键词的组内和整体排序，并根据整体排序赋值的四分位数确定等级框架。结果　群体决策产生符合我国初级保健服务需求的T2DM健康教育关键词28个。通过归纳主题及根据定性数据进行内涵拓展，28个关键词可归类为5个领域主题，分别为糖尿病相关知识、自我管理、社区管理、多病共病管理、治疗和用药。按照两轮排序、分层，最终确定具有4个等级的T2DM患者健康教育内容框架，其中A等级包括排名最高的4个关键词，平均综合得分之和占整体的45.69%。结论　本研究应用NGT构建基于初级保健需求的T2DM健康教育指导性框架，以循证方式确定具备优先度的4层等级和内容。同时，初级保健属于复杂的群体决策环境，基于NGT的结果有助于指南与临床实践达成更高一致性。

关键词: 糖尿病, 2型；健康教育；初级卫生保健；社区卫生服务；名义小组技术；循证医学