Smoliner Andrea, Hantikainen Virpi, Mayer Hanna, Ponocny-Seliger Elisabeth, Them Christa
Privatkrankenanstalt Rudolfinerhaus Wien, Osterreich.
Pflege. 2009 Dec;22(6):401-9. doi: 10.1024/1012-5302.22.6.401.
Patient orientation and patient participation are important aspects of modern health care and should be taken into consideration in the context of nursing care decision-making. The concept of evidence-based nursing also includes patient preferences in participation on decision-making, an area, however, which has not been adequately investigated so far. The aim of the present study was the development and testing of an instrument in German language for collecting data on patients' preferences and the experience of patients regarding their participation in nursing care decision-making in acute hospitals. The generation of items was based on available literature and in collaboration with specialists, using the theoretical model of Charles, Gafni and Whelan (1999). For testing the instrument, data was collected on 967 adult patients in surgical and medical wards of five hospitals in Vienna from October 2007 to March 2008. Test theoretical analyses included checking internal consistency, construct validity and criterion validity. The reliability of the scale preference and experience were confirmed by Cronbach's alpha (> or = 0.84) and the results of item analysis. The construct validity was supported by representing the decision model in the data. The criterion validity (concordant and discriminant validity) was tested with the two external criterions of subjective satisfaction with the information provided and decision making, and was supported by the results both at the level of total scores and at the level of item scores. In summary, the developed instrument represents an adequately reliable and valid test-theoretic, and also model-theoretic instrument for research in the field of evidence-based nursing. Therefore it is capable of gathering new knowledge on patients' preferences on participation in nursing care decision making.
患者导向和患者参与是现代医疗保健的重要方面,在护理决策的背景下应予以考虑。循证护理的概念还包括患者参与决策的偏好,然而,到目前为止,这一领域尚未得到充分研究。本研究的目的是开发并测试一种德语工具,用于收集患者偏好的数据以及患者在急性医院参与护理决策方面的体验。项目的生成基于现有文献,并与专家合作,采用了查尔斯、加夫尼和惠兰(1999年)的理论模型。为了测试该工具,于2007年10月至2008年3月在维也纳五家医院的外科和内科病房对967名成年患者收集了数据。测试理论分析包括检查内部一致性、结构效度和效标效度。量表偏好和体验的信度通过克朗巴赫α系数(≥0.84)和项目分析结果得到证实。数据中呈现的决策模型支持了结构效度。效标效度(一致性和区分效度)通过对所提供信息和决策的主观满意度这两个外部标准进行测试,总分和项目得分层面的结果均提供了支持。总之,所开发的工具是一种在循证护理领域研究中具有足够可靠性和有效性的测试理论及模型理论工具。因此,它能够收集有关患者参与护理决策偏好的新知识。