临床护士不良事件风险感知量表的构建及信效度检验

Structure of Adverse Events Risk Perception Scale and its reliability and validity among clinical nurses

目的：构建临床护士不良事件风险感知量表，并进行信效度检验。方法：通过半结构访谈与开放问卷调查形成量表初稿，然后经专家咨询及预调查进行修改。抽取917名泰安市二、三级医院临床护士进行信效度检验，对量表进行修改并形成终稿。结果：总量表全部条目内容效度指数（CVI）为0.91，各条目CVI为0.71～1.00；利用项目分析和探索性因子分析最终确定20个条目、3个维度，分别为患者照护风险、系统流程风险和护士操作风险，累积方差贡献率为60.374%；验证性因子分析拟合总体较理想（χ2/df=2.427、GFI=0.936、AGFI=0.917、RMSEA=0.049、NFI=0.915、CFI=0.948、IFI=0.948）；量表总体Cronbach’s？α系数为0.939，各维度Cronbach’s？α系数均大于0.70；各条目与量表总分的相关系数为0.46～0.77（P〈0.01）。结论：临床护士不良事件风险感知量表体现出护理服务自身的特点，量表具有良好的信度和效度，可作为临床护士不良事件风险感知的测评工具。

Objective： To explore the structure of Adverse Events Risk Perception Scale and to test its reliability and validity among clinical nurses. Methods： The draft questionnaire was designed by semi-structure interview and open questionnaire survey, and then revised through Delphi Method and a preliminary test. The reliability and validity of the scale were tested among 917 nurses in Taian city. Data were analyzed by SPSS 19.0 software and AMOS 17.0 software. Results： A scale with three factors and 20 items was identiifed by using item analysis and exploratory factor analysis. These three factors could explain 60.374% of the variance. The overall content Validity Index （CVI） was 0.91, while the CVI for each item was ranged from 0.71 to 1.00. The conifrmatory factor analysis revealed a good ift of the model to the data based on various ift indices （χ2/df=2.427, GFI=0.936, AGFI=0.917, RMSEA=0.049, NFI=0.915, CFI=0.948, IFI=0.948）. Exploratory factor analysis and conifrmatory factor analysis revealed that the the three dimensions of adverse events risk perception included patient care risk, system process risk, and nurse operation risk. The Cronbach＇sαcoefifcient of the scale was 0.939 and the Cronbach＇sα coefifcient of each factor was all above 0.7. The correlations of the scores between each item and the total scale were ranged from 0.46 to 0.77 （P〈0.01）. Conclusion： The multi-dimensional structure of adverse events risk perception indicates the characteristics of this nursing service. The Adverse Events Risk Perception Scale is reliable and valid, and can be used to measure adverse events risk perception among clinical nurses.