硬膜外分娩镇痛产妇护理支持需求问卷的研制及信效度检验

Development and reliability and validity tests of the tool of nursing support needs for women with epidural analgesia during labor

目的研制硬膜外分娩镇痛产妇护理支持需求问卷,并检验其信效度。方法以马斯洛需求层次理论和拉扎勒斯的压力与应对模式为理论基础,运用文献分析、半结构式访谈和专家函询法,初步形成硬膜外分娩镇痛产妇护理支持需求问卷;通过预调查对问卷进行调整和修订。采用方便抽样法,于2019年9月—10月选取205名福建省某三级甲等专科医院硬膜外分娩镇痛的产妇进行问卷调查,并对其进行项目分析、信效度检验;于2019年11月—12月选取375名产妇进行验证性因子分析,进一步检验问卷的因子结构。结果硬膜外分娩镇痛产妇护理支持需求问卷包括生理舒适需求、情感支持需求、信息支持需求、技术支持需求4个维度,共32个条目。探索性因子分析提取4个公因子,累计方差贡献率为63.224%。平均量表水平的内容效度指数为0.969,各条目的内容效度指数为0.833~1.000;问卷的Cronbach’sα系数为0.917,重测信度为0.821。验证性因子分析结果显示,模型适配良好,该问卷因子结构稳定。结论硬膜外分娩镇痛产妇护理支持问卷具有较好的信效度,可指导医护人员精准、有针对性地评估产妇需求,为产妇制订个性化的护理计划提供依据,以提高产妇的分娩体验。

Objective To develop the questionnaire of nursing support needs of women with epidural analgesia during labor,and to test its reliability and validity.Methods Based on Maslow’s theory of hierarchical needs and Lazarus’s stress and coping model,using literature review and semi-structured interviews,the pre-trial questionnaire item pool of nursing support needs for women with epidural analgesia during labor was preliminarily formed,and the questionnaire was adjusted and revised through pre-survey.Using the convenience sampling method,205 women who gave birth in a tertiary hospital in Fujian Province from September to October 2019 were selected.The data was analyzed to determine the reliability and validity of the questionnaire.375 women from November to December 2019 were selected for confirmatory factor analysis to further test the factor structure of the questionnaire.Results The questionnaire of nursing support needs for women with epidural analgesia during labor was formed,which included 4 dimensions,namely physiological comfort needs,emotional support needs,information support needs and technical support needs,with 32 items in total.4 common factors were extracted by exploratory factor analysis and the cumulative variance contribution rate was 63.224%.The averaging calculation of content validity index of the questionnaire was 0.969,and the content validity index of items range from 0.833 to 1.000.The total Cronbach’sαcoefficient of the questionnaire was 0.917,and the total test-retest reliability coefficient was 0.821.The results of confirmatory factor analysis showed that the model fits well,indicating that the factor structure of the questionnaire was stable.Conclusion The questionnaire had good reliability and validity,which can guide the medical staff to accurately evaluate the needs of women with epidural analgesia during labor,and provide the basis for them to develop personalized nursing plan,so as to improve their delivery experience.