心肌梗死住院病人核心护理结局的修订、信效度检验及初步应用

Revision,reliability and validity test and preliminary application of core nursing outcomes for inpatients with myocardial infarction

[目的]修订核心护理结局,以修订的部分量表为测评工具在心肌梗死住院病人中进行应用,准确测量护理措施的有效性。[方法]采用专家咨询法完成核心护理结局的修订。应用问卷调查法进行临床测量,分析其信度与效度。将“危险控制:心血管健康”和“自理:日常生活活动能力”两个护理结局进行初步临床应用,测量出入院时病人结局得分情况,分析临床护理效果。[结果]经过专家咨询法共修订出7项(包括88个条目)结局,Cronbach′sα系数为0.878~0.980,分半信度为0.810~0.937,量表的内容效度指数(S-CVI)为0.91~0.95,各条目的内容效度指数(I-CVI)为0.82~1.00。两个结局测评结果显示出入院时护理结局得分差异有统计学意义(P<0.01)。[结论]修订后的结局指标不仅信效度良好而且更符合本土化要求,可以方便、快捷、有效地捕捉到病人的护理问题,为临床一线工作人员提供便捷有效的测评工具,为下一步实施护理措施提供参考依据。

Objective: To revise the core nursing outcomes,and to accurately measure the effectiveness of nursing measures by using the revised partial scale as the evaluation tool in inpatients with myocardial infarction. Methods: The expert consultation method was used to revise the core nursing outcomes.The reliability and validity were analyzed by questionnaire survey.Preliminary clinical application was performed on two nursing outcomes.Two nursing outcomes that were "risk control:cardiovascular health" and "self-care:activity of daily living",were preliminarily applied in clinical practice.The nursing outcomes scores of patients at the time of admission and discharge were measured. And the clinical nursing effect were analyzed. Results: A total of 7 nursing outcomes(including 88 items) were revised after expert consultation.Cronbach′s a coefficient was at 0.878~0.980.The split-half reliability was 0.810~0.937.Content validity index(S-CVI)of the scale was 0.91~0.95.And content validity index(I-CVI)of each item was 0.82~1.00.The results of the two nursing outcomes tests showed that there was a statistically significant difference in terms of the scores of nursing outcome on admission( P <0.01). Conclusions: The revised nursing outcomes indicators not only had good reliability and validity,but also could meet the requirements of localization.They could easily,quickly and effectively capture the nursing problems of patients, provide convenient and effective evaluation tools for clinical front-line staff,and provide reference for the next step of nursing measures.