中青年临终患者照护需求量表编制及信效度检验

Development of the Care Needs Scale for Young and Middle-aged Terminally Ill Patients and its reliability and validity

目的 编制中青年临终患者照护需求量表并对其信效度进行检验,旨在为医护人员提供有效的中青年临终患者照护需求评估工具.方法 本研究为横断面研究.以支持性照护需求理论为指导,通过文献回顾、质性访谈、德尔菲专家函询法及预调查形成初始量表.采用便利抽样法,选取2022年7-9月在天津市6所三级医院肿瘤科和临终关怀病房住院的570例中青年临终患者为研究对象,对其进行问卷调查.采用项目分析法对量表条目进行筛选;应用探索性因子分析和验证性因子分析评价量表的结构效度;采用量表水平内容效度指数和条目水平内容效度指数评价量表的内容效度;采用内部一致性系数和折半信度系数评价量表的信度.本研究共发放问卷570份,回收有效问卷565份,有效回收率为99.12%(565/570).结果 本研究共18名专家完成2轮函询,专家权威系数均为0.890,肯德尔和谐系数分别为0.309和0.417(P<0.05).中青年临终患者照护需求量表包含6个维度,共39个条目.探索性因子分析提取出6个公因子,累积方差贡献率为71.515%.验证性因子分析结果显示,整体模型拟合较好.量表水平的内容效度指数为0.942,条目水平的内容效度指数为0.833~1.000.总量表的Cronbach's α系数为0.975,折半信度系数为0.911.结论 中青年临终患者照护需求评估量表的信效度良好,可作为中青年临终患者照护需求的评估工具.

Objective To develop the Care Needs Scale for Young and Middle-aged Terminally Ill Patients and test its reliability and validity,so as to provide an effective tool for evaluating the care needs of young and middle-aged terminally ill patients for medical and nursing staff.Methods This study is a cross-sectional study.Guided by the theory of supportive care needs,an initial scale was formed through literature review,qualitative interviews,Delphi expert consultation,and pre-survey.From July to September 2022,convenience sampling was used to select 570 young and middle-aged terminally ill patients hospitalized in the Oncology Department and Hospice Care Ward of six ClassⅢhospitals in Tianjin as the research subject,and a questionnaire survey was conducted on the patients.The items in the scale were selected using item analysis method.The structural validity of the scale was evaluated using exploratory factor analysis and confirmatory factor analysis.The content validity of the scale was evaluated using the scale-level content validity index and the item-level content validity index.The reliability of the scale was evaluated using internal consistency coefficient and half reliability coefficient.A total of 570 questionnaires were distributed,and 565 valid questionnaires were collected,with an effective response rate of 99.12%(565/570).Results A total of 18 experts completed two rounds of consultation,with an expert authority coefficient of 0.890,the Kendall's W values of 0.309 and 0.417,respectively(P<0.05).The Care Needs Scale for Young and Middle-aged Terminally Ill Patients included 6 dimensions and a total of 39 items.Exploratory factor analysis extracted 6 common factors,with a cumulative variance contribution rate of 71.515%.Confirmatory factor analysis showed that the overall model fitted well.The content validity index at the scale level was 0.942,and the content validity index at the item level was 0.833 to 1.000.The total Cronbach'sαcoefficient of the scale was 0.975,and the half reliability coefficient was 0.911.Conclusions The reliability and validity of the Care Needs Scale for Young and Middle-aged Terminally Ill Patients are good,and it can be used as an evaluation tool for the care needs of young and middle-aged terminally ill patients.