综合医院认知障碍患者护理困难量表的编制和信效度检验

Development and psychometric testing of the nursing practice difficulty scale for nurses caring for patients with dementia in general hospitals

目的随着中国老龄化速度的加快,患有认知障碍的患者住院率逐渐上升。目前,针对中国综合医院认知障碍患者护理困难的研究相对有限。该研究编制了针对综合医院护士的认知障碍患者护理困难量表,并验证其效度和信度。方法以生物-心理-社会医学理论模型为指导,通过文献查阅、定性访谈、专家咨询拟订初始量表。2021年9月至11月,对11所综合性医院的313名护士进行调查。采用项目分析、探索性因子分析、已知组别法和并存效度,验证量表的效度。采用Cronbach'sα系数和分半可靠性评估量表的信度。结果各条目内容效度指数(I-CVI)为0.833~1.00,总内容效度指数(S-CVI)为0.929。通过项目分析和探索性因子分析提取了21个项目,涉及4个因子。根据已知组别法,认知障碍护理经验丰富组和有认知障碍护理培训经历组的护理困难程度,显著低于经验较少组和未接受过培训组。综合医院认知障碍患者护理困难量表与护士工作压力源量表的相关系数为0.387,与认知障碍护理态度量表的相关系数为-0.239。各维度的Cronbach'sα系数为0.889~0.905,总的Cronbach'sα系数为0.959。各维度的折半系数为0.814~0.894,总体为0.911。结论该研究制订了综合医院认知障碍患者护理困难量表,并提取了4个因子,验证了该量表的信度和效度。该量表可用于评估综合医院认知障碍患者护理实践的难度,并可用于未来的研究以改善认知障碍患者的护理实践。

Objective:As aging in the Chinese population increases,the hospitalization rates of patients with dementia have also risen.Research on the difficulties of nurses who care for patients with dementia in Chinese general hospitals is limited.This study aimed to develop a scale to measure the difficulties nurses face in nursing patients with dementia in Chinese general hospitals and to verify its reliability and validity.Methods:Guided by the biopsychosocial theory,an initial scale was created through a literature review,qualitative interviews,and expert consultation.A web-based survey for psychometric testing was conducted with 394 nurses from 11 general hospitals during September to November 2021.Validity was verified using content validity,exploratory factor analysis,the known-groups method,and concurrent validity.Cronbach’s a coefficient and split-half reliability were used to assess reliability.Results:The Item-level Content Validity Index was 0.833e1.000.The Scale-level Content Validity Index was 0.929.Twenty-one items with four factors were extracted from the item analysis and exploratory factor analysis.According to the known-groups method,the difficulty of the experienced group and the group with training experience was significantly lower than that of the less experienced group and the group without training experience.Based on external standards,the correlation coefficient was 0.387 with the Nursing Job Stress Scale and0.239 with the Dementia Care Attitude Scale.Cronbach’s a coefficient for each factor ranged from 0.889 to 0.905,and the total was 0.959.The split-half reliability for each factor ranged from 0.814 to 0.894,and the total was 0.911.Conclusion:This study discovered a four-factor structure related to the difficulty scale of dementia nursing practice,and the scale’s reliability and validity were confirmed.The scale can be utilized to assess the difficulty of dementia nursing practice in general hospitals and may be employed in future research to improve dementia nursing practices.