护理活动评估量表的修订及信效度检验

Revision and test of reliability and validity of Nursing Activities Score

目的:修订护理活动评估量表(NAS),进行信效度评价。方法:在NAS框架基础上,通过查阅相关量表、临床实际测量、专家小组讨论、临床试用情况,形成修订版NAS。采用便利抽样方法,在某三级甲等医院4个重症监护病房(ICU)内抽取200例病人,使用修订版NAS对病人进行24 h护理工作量评估。采用Cronbach'sα系数、分半信度和评价者间信度评价修订版NAS的信度,采用结构效度验证该量表的效度。结果:修订版NAS包括8个维度、20个护理项目;Cronbach'sα系数为0.71,分半信度系数为0.83,两评分者间Spearman相关系数为0.89;应用主成分分析法和最大方差正交旋转法共提取7个公因子,累计解释变异量为67.35%。结论:修订版NAS具有较好的信度、效度,符合现阶段我国ICU护理特点,护理工作量测量更精准,可为ICU护理工时的测定提供有效的工具。

Objective:To revise the Nursing Activities Score(NAS)and test its reliability and validity.Methods:Based on the NAS framework,a revised version of NAS was formed by consulting-related scales,actual clinical measurements,expert group discussions,and clinical trials.A total of 200 patients were selected from 4 intensive care units(ICU)of a tertiary grade A hospital using the convenience sampling method.The revised version of the NAS was used to evaluate the patient's 24-hour nursing workload.Cronbach'sαcoefficient,split⁃half reliability,and inter⁃rater reliability were used to evaluate the reliability of the revised NAS,and the validity of the scale was verified by structure validity.Results:The revised NAS included 8 dimensions and 20 nursing items;Cronbach'sαcoefficient was 0.71,split⁃half reliability coefficient was 0.83,and the Spearman correlation coefficient between the two raters was 0.89.A total of 7 common factors were extracted by principal component analysis and maximum variance orthogonal rotation,and the cumulative explained variance was 67.35%.Conclusions:The revised version of NAS has good reliability and validity,which is in line with the characteristics of ICU nursing at this stage in China.The measurement of nursing workload was more accurate,and it could provide an effective tool for the determination of nursing hours in ICU.