Pelander Tiina, Leino-Kilpi Helena, Katajisto Jouko
Department of Nursing Science, University of Turku, Finland.
J Adv Nurs. 2009 Feb;65(2):443-53. doi: 10.1111/j.1365-2648.2008.04875.x. Epub 2008 Nov 6.
This paper is a report of the development and psychometric evaluation of the Child Care Quality at Hospital (CCQH) instrument.
Recent years have shown a growing recognition of children's rights and the need to listen to and consult with children, especially at an international level, including in the hospital setting. Children's views should be considered in the planning and delivery of paediatric nursing care. However, previous work has tended to concentrate on medical rather than nursing care.
The CCQH instrument was developed in three phases. First, in 2004 following a literature review and interviews/drawings by hospitalized children (n = 40), the items were designed and an expert panel (n = 7) assessed the instrument's content validity (phase I). Revisions were made based on children's interviews (n = 8), children's questionnaires (n = 41, 16) and nurses' evaluations (n = 19, 198) in phases II and III in 2004 and 2005 respectively. Construct validity was assessed in phase III by means of principal component analysis. The instrument's reliability was statistically tested in phases II and III.
The main quality categories were nurse characteristics, nursing activities and environment. For each category, Cronbach's alpha values improved during the development process. Principal component analysis supported the theoretical construct of the subcategories in the nursing activities and environment categories.
The CCQH questionnaire is a promising instrument for use among children. Future research is needed to evaluate its suitability for completion by children of varying ages and in different cultures and healthcare settings.
本文报告了医院儿童护理质量（CCQH）工具的开发及心理测量学评估情况。
近年来，人们越来越认识到儿童权利以及倾听儿童意见并与之协商的必要性，尤其是在国际层面，包括在医院环境中。在儿科护理的规划和实施过程中应考虑儿童的观点。然而，以往的工作往往集中在医疗护理而非护理方面。
CCQH工具分三个阶段开发。首先，2004年在进行文献综述并对40名住院儿童进行访谈/绘图后，设计了条目，并由一个7人专家小组评估该工具的内容效度（第一阶段）。分别在2004年和2005年的第二阶段和第三阶段，根据对8名儿童的访谈、41份（16份）儿童问卷以及19份（198份）护士评估结果进行了修订。在第三阶段通过主成分分析评估结构效度。在第二阶段和第三阶段对该工具的信度进行了统计学检验。
主要的质量类别包括护士特征、护理活动和环境。对于每个类别，在开发过程中克朗巴哈系数值均有所提高。主成分分析支持了护理活动和环境类别中各子类别的理论结构。
CCQH问卷是一种很有前景的供儿童使用的工具。未来需要开展研究，以评估其对于不同年龄、不同文化背景及不同医疗环境下儿童填写的适用性。
