肠造口患者出院后护理需求量表的编制及信效度研究

发布时间：2018-08-08 12:41

【摘要】：目的:构建肠造口患者出院后护理需求量表,并检验其信效度。为护理工作者进行支持性照护提供有效评估工具,为护理工作者实施有针对性的护理干预提供理论参考依据。方法:(1)条目池形成:通过调研国内外的相关文献,以马斯洛需要理论为框架,结合小组讨论,运用质性研究,对吉林省3家三级甲等医院出院后的12名肠造口患者进行半结构式访谈调研,深入了解造口患者出院后的护理需求内容(访谈时间为:2015年9月-10月),对访谈录音资料进行整理分析后,形成肠造口患者出院后护理需求量表条目池。(2)预试量表形成:选取国内6家三级甲等医院的9位肠造口医疗、护理专家,运用德尔菲法,通过两轮专家函询对条目进行筛选及内容效度评定,删除内容表达不清的条目,增加认为应补充的条目,形成6个维度的预试量表。采用目的抽样法对吉林省3家三级甲等医院20名出院后的肠造口患者进行小样本测试(2015年11月-2016年1月)。(3)量表形成及检验:2016年2月-10月,通过便利抽样法,选取吉林省3家三级甲等医院结直肠科行肠造口术后已出院患者200名,进行量表临床施测后,收集该量表的相关数据,并利用决断值法、相关系数法和内部一致性系数法,再进一步判断该量表条目有无增减,并采用内部一致性信度、分半信度、重测信度、内容效度和结构效度对量表各条目进行信效度分析。结果:(1)量表形成情况本研究通过文献回顾、患者质性访谈结合对专家进行德尔菲法函询后,经过小样本预调查,再对条目进行统计学筛选后形成6个维度、24个条目的正式测试量表。(2)量表的信度本研究量表的总Cronbach’a系数为0.751,各维度Cronbach’a系数为在0.968-0.974,均在0.7以上,说明内部一致性较好。量表的折半信度为0.794;重测信度为0.827。(3)量表的效度量表总体的内容效度S-CVI为0.968,24个条目的I-CVI值在0.78-1.00。量表总体适当性量数KMO值为0.913,指标值大于0.900,表示变量间有共同因素存在;Bartlett球形检验的近似卡方分布为4653.818,自由度为276,显著性概率值P≤0.01,达到显著水平,说明量表项目适合进行因素分析。提取主成分6个,6个主成分累积解释变异程度为91.753%,说明该量表具有较好的效度。结论:(1)本研究完成了肠造口患者出院后护理需求量表的编制。量表内容包括6个维度、24个条目。(2)量表信效度较为理想,能够科学、准确、全面的反映肠造口患者出院后的护理需求,可以利用本量表对其进行护理需求的评估。
[Abstract]:Objective: to construct a nursing demand table for patients with enterostomy after discharge and to test its reliability and validity. To provide an effective evaluation tool for nursing workers to carry out supportive care, and to provide theoretical reference for nursing workers to carry out targeted nursing intervention. Methods: (1) the formation of item pool: by investigating the relevant literature at home and abroad, taking Maslow's needs theory as the frame, combining with group discussion, using qualitative research, Twelve patients with enterostomy after discharge from 3 Grade 3A hospitals in Jilin Province were investigated with semi-structural interviews. After deeply understanding the nursing needs of the patients who were discharged from the hospital (interview time: September-October 2015), after sorting out and analyzing the recorded interview materials, (2) formation of pre-test scale: select 9 enterostomy medical experts from 6 Grade 3A hospitals in China, and use Delphi method. The items were screened and evaluated by two rounds of expert letter, the items which were not clearly expressed were deleted, the items that should be supplemented were added, and the pre-test scale of six dimensions was formed. Objective to test the formation and test of small sample (). (3) scale in 20 patients with enterostomy after discharge from 3 Grade 3A hospitals in Jilin province from November 2015 to January 2016. Two hundred patients who had been discharged from hospital after colorectostomy were selected from 3 Grade 3A hospitals in Jilin province. The data of the scale were collected after clinical test, and the determination value method, correlation coefficient method and internal consistency coefficient method were used to collect the relevant data of the scale. Furthermore, the internal consistency reliability, split-half reliability, test-retest reliability, content validity and structural validity were used to analyze the reliability and validity of each item of the scale. Results: (1) the form of the scale was studied by literature review, qualitative interviews with experts were conducted by Delphi method, and a small sample was pre-investigated. After statistical screening, 6 dimensions and 24 items of formal test scale were formed. (2) the total Cronbach'a coefficient of reliability of the scale was 0.751, and the Cronbach'a coefficient of each dimension was 0.968-0.974, all above 0.7, indicating that the internal consistency was better. The compromise reliability of the scale was 0.794, and the test-retest reliability was 0.827. (3) the overall content validity of the scale was 0.368, and the I-CVI of 24 items was 0.78-1.00. The KMO value of the total fitness of the scale was 0.913, and the index value was greater than 0.900. The approximate chi-square distribution of Bartlett spherical test was 4653.818, and the degree of freedom was 276.The significant probability value P 鈮，

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