College of Nursing, University of Utah, Salt Lake City, UT 84112-5880, USA.
Nurs Res. 2010 Mar-Apr;59(2):85-92. doi: 10.1097/NNR.0b013e3181d1a732.
Research to document the effects of nursing on patient outcomes such as pain has been limited by the inability to measure the quality of nursing care effectively.
The purpose of this study was to establish content validity and to evaluate patient understanding of Pain Care Quality (PainCQ) survey items using cognitive interviewing.
In the development phase, 101 items representing four constructs were generated from the transcriptions of 33 qualitative interviews conducted with cancer patients in pain. In the judgment phase, items were reviewed systematically by two panels of pain experts. In the final phase, cognitive interviews were conducted with hospitalized cancer patients reporting pain.
Content validity was established if eight of nine (p < .05) experts agreed the item was relevant or very relevant. On the basis of the expert panel review, items were deleted, reworded, and added, and 73 items remained. These items were evaluated by cognitive interviews with 39 hospitalized patients with multiple types of cancer in three states. The mean age was 58.87 years, and 60.5% were women. Most were non-Hispanic White (94.7%), and education varied. On a 0 to 10 scale, worst pain during the past shift averaged 5.24 (SD = 2.43). Participant responses to the PainCQ survey items were summarized for each item using a matrix tool and evaluated in team meetings. Through an iterative process, items were revised and reduced to produce the PainCQ survey (v3) with 44 items.
Through this deliberative and iterative process, an instrument was produced that will contribute to the measurement of the quality of nursing and interdisciplinary care related to pain management. The items retained in the PainCQ were understood and judged by hospitalized patients with pain easily. Further psychometric testing of the PainCQ is indicated.
由于无法有效衡量护理质量，因此针对护理对患者结局（如疼痛）影响的研究受到限制。
本研究旨在通过认知访谈，确定 PainCareQuality（PainCQ）调查项目的内容效度，并评估患者对其的理解。
在开发阶段，从 33 名处于疼痛中的癌症患者的 33 次定性访谈的转录中生成了 101 个项目，代表 4 个构念。在判断阶段，两个疼痛专家小组对项目进行了系统审查。在最后阶段，对报告疼痛的住院癌症患者进行了认知访谈。
如果 9 位专家中的 8 位（p<0.05）认为项目相关或非常相关，则可以确定内容效度。根据专家小组的审查，删除、改写和添加了一些项目，最后保留了 73 个项目。在来自三个州的 39 名患有多种类型癌症的住院患者的认知访谈中对这些项目进行了评估。平均年龄为 58.87 岁，60.5%为女性。大多数是非西班牙裔白人（94.7%），教育程度各异。过去轮班期间最严重疼痛的平均得分为 5.24（SD=2.43）。参与者使用矩阵工具对 PainCQ 调查的每个项目进行了总结，并在团队会议上进行了评估。通过迭代过程，对项目进行了修订和简化，从而产生了包含 44 个项目的 PainCQ 调查（v3）。
通过这个深思熟虑和迭代的过程，开发出了一种工具，将有助于衡量与疼痛管理相关的护理和跨学科护理的质量。保留在 PainCQ 中的项目易于被患有疼痛的住院患者理解和判断。还需要对 PainCQ 进行进一步的心理测量学测试。
