关节镜日间手术患者延续护理需求问卷的编制及信度、效度检验

Development of transitional care need questionnaire for osteoarticular day surgery patients and its reliability and validity

目的 编制关节镜日间手术患者延续护理需求问卷,并检验其信度、效度,为临床提供评估工具。方法 2022年8月—12月以奥马哈问题分类系统为指导框架,通过文献回顾、质性访谈建立问卷条目池,选择全国6个省市临床护理、护理管理、临床医学、康复医学等6个领域的15名专家,采用德尔菲法对该问卷进行两轮专家函询构建问卷初稿;2023年3月—8月采用便利抽样法,选取山东省济南市4所三级甲等综合医院的280例关节镜日间手术患者进行问卷调查,并检验其信度与效度。结果 两轮专家函询的积极系数分别为83.33%和100.00%,权威程度系数均为0.82,该指标Kendall协调系数W分别为0.169和0.218,第一轮函询二级指标各条目的重要性均数为4.13~4.80分,该指标变异系数为0.086~0.208,满分率为33.33%~80.00%;第二轮函询二级指标各条目的重要性均数为4.20~5.00分,该指标变异系数为0.00~0.18,满分率为40%~100.00。共调查280例患者,问卷总的Cronbach α系数为0.922,折半信度为0.79;问卷总体水平的内容效度指数(scale-level content validity index,S-CVI)以及问卷条目水平的内容效度指数(item-level content validity index,I-CVI)均为1;探索性因子分析KMO值为0.925,Bartlett’s球形检验值为5456.320(P<0.001),累计方差贡献率为63.319%。经信度、效度检验后形成包含环境领域2个条目、心理社会领域5个条目、生理领域15个条目、健康相关行为领域8个条目共30个条目的正式版问卷。结论 关节镜日间手术患者延续护理需求问卷具有良好的信度、效度,适用于评估我国关节镜日间手术患者延续护理的相关需求。

Objective To develop a questionnaire on the transitional care needs of patients undergoing arthroscopic day surgery and to test its reliability and validity.Methods Based on the Omaha Question Classification System,the questionnaire item pool was constructed after literature reviews and qualitative interviews.A questionnaire-based scale was drafted based on the established item pool by carrying out two rounds of consultation with 15 experts in clinical nursing,nursing management,clinical medicine,rehabilitation medicine,and other fields from 6 provinces or cities in China.Reliability and validity of the scale were tested using convenience sampling,involving 280 patients with arthroscopic day surgery from 4 general hospitals in Jinan of Shandong province,China,between March and August 2023.Results The response rates for the two rounds of expert consultation were 83.33%and 100.00%,respectively.The authority coefficients of the two rounds both was 0.82,and the coordination coefficients for the 2 rounds were 0.169 and 0.218,respectively.In the first round,the average importance rating of secondary index was from 4.13 to 4.80 with the coefficient of variation from 0.086 to 0.208,and the full score ratio from 33.33%to 80.00%.In the second round,the average importance rating of secondary index ranged from 4.20 to 5.00 with the coefficient of variation from 0.00 to 0.18,and the full score ratios from 40%to 100.00%.A total of 280 patients completed the survey.The overall Cronbach’s α coefficient of the scale was 0.922,the overall split-half reliability was 0.79,the scale-level content validity index(S-CVI)and the item-level content validity index(I-CVI)of the total scale all was 1.The KMO value of exploratory factor analysis was 0.925,the Bartrett spherical test value was 5456.320(P<0.001),and the cumulative variance contribution rate was 63.319%.After the reliability and validity tests,the scale was finalised and determined to consist of four dimensions with 30 items:environmental field(2 items),psychosocial field(5 items),physiological field(15 items)and health-related behavior field(8 items).Conclusion The questionnaire on the transitional care needs of patients undergoing arthroscopic day surgery has good reliability and validity and makes it an effective assessment tool for the transitional care need of arthroscopic day surgery patients.