护士工作场所心理健康问卷及信效度检验

Development and validation of the Nurse’s Workplace Mental Health Questionnaire

目的编制护士工作场所心理健康问卷并验证其信度和效度。方法以Keyes提出的心理健康双因素模型为理论基础,结合文献回顾法、德尔菲专家咨询法编制初始问卷,并进行预调查。于2020年6月—7月采用便利抽样法,对我国11个省公立医院的2815名临床护士进行网络问卷调查,验证问卷的信度和效度。结果问卷的条目内容效度指数(I-CVI)为0.750-1.000,平均内容效度指数(S-CVI/Ave)为0.910。问卷的Cronbach’sα系数为0.948,重测信度为0.850。护士工作场所心理健康问卷与抑郁自评量表相关系数为-0.664(P<0.01)。探索性因子分析共提取出6个公因子,为情绪状态、心理安全感、积极关系、心理韧性、自我效能与主观幸福感。问卷共包含32个条目,累计方差贡献率为65.58%。验证性因子分析结果显示,模型拟合良好,该问卷因子结构稳定。结论护士工作场所心理健康问卷的信度和效度较好,有助于评估护士的心理健康状况,并帮助护理管理者制订针对性的心理干预措施。

Objectives:This study aimed to develop and validate the Nurse’sWorkplace Mental Health Questionnaire(NWMHQ).Methods:The questionnaire was developed based on the two continua model of mental illness and health proposed by Keyes.The initial questionnaire was generated through literature review,two rounds of Delphi expert consultation,followed by a pilot survey.Finally,the reliability and validity of the questionnaire were validated through an online survey of 2,815 registered nurses selected from the public hospitals in 11 provinces from June to July 2020.Results:The item-content validity index(I-CVI)of the questionnaire ranged from 0.750 to 1.000 and the average scale-level content validity index(S-CVI/Ave)was 0.906.Cronbach’s a coefficient was 0.948 and test-retest reliability was 0.850.The self-rating depression scale score was negatively related to the NWMHQ score(r=0.664,P<0.01).The exploratory factor analysis(EFA)yielded six factors(emotional status,psychological security,positive relationship,resilience,self-efficacy,and subjective well-being),consisting of 32 items.The cumulative variance contribution rate was 65.58%.Confirmatory factor analysis(CFA)showed an acceptable fit.Conclusion:The NWMHQ developed in this study showed good reliability and validity.This questionnaire may help assess the mental health status of nurses and help nursing managers to develop appropriate targeted psychological interventions.