Slater Paul, McCormack Brendan, Bunting Brendan
Royal Hospitals Trusts/Institute of Nursing Research, University of Ulster, Jordanstown, Northern Ireland.
Worldviews Evid Based Nurs. 2009;6(3):173-82. doi: 10.1111/j.1741-6787.2009.00159.x. Epub 2009 Jul 27.
Evidence shows that adopting a person-centered approach to nursing alters the work environment, reduces anxiety levels among nurses in the long term, promotes teamwork among staff, and increases job satisfaction. However, few studies have attempted to quantify the outcomes from the adoption of person-centered nursing. The lack of outcome measurement is in part influenced by the lack of a standardized instrument to measure person-centered nursing.
The aim of this study was to develop an instrument (the Nursing Context Index) to inform the development of person-centered nursing and outcomes arising.
The Nursing Context Index (NCI) was developed through three stages. Stage 1 involved a systematic literature review to identify the key characteristics that needed to be considered in the instrument. Stage 2 involved the identification and selection of items for inclusion in the instrument identified through focus group discussions. A 19-construct instrument was developed. Face validity and content validity were gauged. In Stage 3, a pilot study (n = 23) was conducted to test the instrument. Measures of internal consistency were ensured using Cronbach's alpha. Criterion-related validity of the instrument was ensured through comparison between factors contained in the instrument.
Findings show that the NCI is an accurate representation of the factors influenced by a clinical setting's progression to person-centered nursing. The factors were deemed appropriate to the clinical settings, and possessed face and content validity. Initial statistical findings confirm the validity and usability of the NCI.
The process used for the development and testing of the instrument was found to be effective. The NCI was deemed to be an effective measure of factors influenced by the implementation of person-centered nursing and would help in redressing a scarcity of quantitative evidence to examine the benefits of nurses working in a person-centered manner.
有证据表明，采用以患者为中心的护理方法会改变工作环境，长期降低护士的焦虑水平，促进员工之间的团队合作，并提高工作满意度。然而，很少有研究试图量化采用以患者为中心的护理所产生的结果。缺乏结果测量部分是由于缺乏用于测量以患者为中心的护理的标准化工具。
本研究的目的是开发一种工具（护理情境指数），以指导以患者为中心的护理及其产生的结果的发展。
护理情境指数（NCI）通过三个阶段开发。第一阶段包括系统的文献综述，以确定该工具中需要考虑的关键特征。第二阶段包括通过焦点小组讨论确定并选择纳入该工具的项目。开发了一个包含19个结构的工具。评估了表面效度和内容效度。在第三阶段，进行了一项试点研究（n = 23）以测试该工具。使用克朗巴哈系数确保内部一致性的测量。通过比较该工具中包含的因素来确保该工具的效标关联效度。
研究结果表明，NCI准确反映了受临床环境向以患者为中心的护理发展影响的因素。这些因素被认为适用于临床环境，并具有表面效度和内容效度。初步统计结果证实了NCI的有效性和可用性。
发现用于开发和测试该工具的过程是有效的。NCI被认为是衡量受以患者为中心的护理实施影响的因素的有效指标，将有助于弥补缺乏定量证据来检验护士以患者为中心工作的益处的不足。
