基于患者报告的ICU过渡期护理质量评测量表编制及信效度检验

Development and reliability and validation of a quality of patient-reported ICU transitional care scale

目的编制基于患者报告的ICU过渡期护理质量评测量表,并检验其性能。方法参考患者报告临床结局量表研制指南,在ICU过渡期护理扎根理论研究基础上,结合国内外相关文献、ICU过渡期患者体验与需求,构建基于患者报告的ICU过渡期护理质量评测量表条目池;通过患者认知测试与Delphi专家函询法,形成初始量表。采用便利抽样方法选取天津市第三中心医院2019年3—8月由ICU转出至普通病房患者177例行项目分析并验证量表信度、效度。结果2轮专家函询积极系数均在0.90以上,权威系数均为0.785。正式量表共包括28个条目,探索性因子分析共提取4个公因子,分别为自护准备、沟通协调、心理支持和健康信念,累计方差贡献率为78.307%。各条目内容效度指数为0.769~1.000,量表总内容效度为0.896。量表4个因子和总量表的Cronbachα系数分别为0.844、0.793、0.897、0.681和0.807。结论本研究构建的基于患者报告的ICU过渡期护理质量评测量表具有良好的信效度,可作为临床工作中ICU过渡期护理质量的辅助评价工具。

Objective To develop a quality assessment scale of ICU transitional care based on patient-reported outcomes and test its performance.Methods According to the guidelines of patient-reported outcomes development process,the item pool was established combining with analysis of relevant literatures and patients′experience and needs in ICU transitional period based on the grounded theory about ICU transitional care.Cognitive test of patients and Delphi expert correspondence were utilized to amend the initial scale before pretest.One hundred and seventy-seven patients who had been transferred from ICU to general ward from March to August 2019 in Tianjin Third Central Hospital were recruited by convenience sampling method for project analysis.Results The active coefficient and authority degree of expert were above 0.90 and 0.785 respectively for the two rounds of expert enquiry.The final scale consisted of 28 items,from which 4 principal factors,which were preparation for self-care,communication and coordination,psychological support and health belief,respectively,were extracted by exploratory factor analysis,explaining 78.307%of total variance.The content validity index of each item was 0.769-1.000,and the scale-level content validity was 0.896.The Cronbachαcoefficients of the 4 factors and the scale were 0.844,0.793,0.897,0.681 and 0.807,respectively.Conclusions The patient-reported outcomes scale measuring ICU transitional care quality has good reliability and validity and can be used as an auxiliary tool measuring ICU transitional care quality in clinic.