McCormack Brendan, McCarthy Geraldine, Wright Jayne, Slater Paul, Coffey Alice
Institute of Nursing Research/School of Nursing, University of Ulster, County Antrim, Northern Ireland.
Worldviews Evid Based Nurs. 2009;6(1):27-35. doi: 10.1111/j.1741-6787.2008.00130.x. Epub 2009 Jan 16.
To test the psychometric properties of the Context Assessment Index (CAI).
We used the Promoting Action on Research Implementation in Health Services Framework (PARIHS) as the theoretical framework for the study. The framework shows the successful implementation of evidence in practice as dependent on the inter-relationship of the nature of the evidence, the quality of the context, and expert facilitation. However, a comprehensive method of assessing context has not yet been available.
A five-stage instrument development and testing methodology was used. Principal components analysis, exploratory factor analysis, and expert panel feedback were used to develop and refine the CAI model. The model was further tested for psychometric properties of internal consistency and test-retest scores. Telephone interviews were conducted with expert nurses to gauge the usability of the instrument. These stages of development and testing resulted in a final 37-item, five-factor CAI model.
This 37-item model was accepted as a reasonable explanation of the data. The measures of homogeneity were calculated for each of the five factors to measure internal reliability. The Cronbach's alpha score for the complete questionnaire was estimated at 0.93. All five factors achieved a satisfactory estimated level of internal consistency in scoring, ranging from 0.78 to 0.91. Test-retest scores indicate reliability of the findings, and the feedback from focus group participants suggests that the instrument has practical utility.
The CAI provides clinicians with the means to assess and understand the context in which they work and the effect this has on using evidence in practice.
检验情境评估指数（CAI）的心理测量特性。
我们采用卫生服务研究实施促进行动框架（PARIHS）作为本研究的理论框架。该框架表明，实践中证据的成功实施取决于证据的性质、情境质量和专家引导之间的相互关系。然而，尚未有全面的情境评估方法。
采用五阶段的工具开发与测试方法。运用主成分分析、探索性因素分析和专家小组反馈来开发和完善CAI模型。对该模型进一步进行内部一致性和重测分数的心理测量特性测试。通过电话访谈专家护士来评估该工具的可用性。这些开发和测试阶段最终形成了一个包含37个项目、五个因素的CAI模型。
这个包含37个项目的模型被认为是对数据的合理解释。计算五个因素各自的同质性度量以测量内部信度。完整问卷的克朗巴哈系数估计为0.93。所有五个因素在评分方面均达到了令人满意的内部一致性估计水平，范围从0.78到0.91。重测分数表明了研究结果的可靠性，焦点小组参与者的反馈表明该工具具有实际效用。
CAI为临床医生提供了评估和理解其工作情境以及该情境对实践中使用证据的影响的方法。
