Zhou Guiyun, Stoltzfus Jill C, Houldin Arlene D, Parks Susan M, Swan Beth Ann
Vita Medical Associates, Bethlehem, PA, USA.
Oncol Nurs Forum. 2010 Nov;37(6):E400-10. doi: 10.1188/10.ONF.E400-E410.
PURPOSE/OBJECTIVES: To establish initial reliability and validity of a Web-based survey focused on oncology advanced practice nurses' (APNs') knowledge, attitudes, and practice behaviors regarding advanced care planning, and to obtain preliminary understanding of APNs' knowledge, attitudes, and practice behaviors and perceived barriers to advanced care planning.
Descriptive, cross-sectional, pilot survey study.
The eastern United States.
300 oncology APNs.
Guided by the Theory of Planned Behavior, a knowledge, attitudes, and practice behaviors survey was developed and reviewed for content validity. The survey was distributed to 300 APNs via e-mail and sent again to the 89 APNs who responded to the initial survey. Exploratory factor analysis was used to examine the construct validity and test-retest reliability of the survey's attitudinal and practice behavior portions.
Respondents' demographics, knowledge, attitudes, practice behaviors, and perceived barriers to advanced care planning practice.
Exploratory factor analysis yielded a five-factor solution from the survey's attitudes and practice behavior portions with internal consistency using Cronbach alpha. Respondents achieved an average of 67% correct answers in the 12-item knowledge section and scored positively in attitudes toward advanced care planning. Their practice behavior scores were marginally positive. The most common reported barriers were from patients' and families' as well as physicians' reluctance to discuss advanced care planning.
The attitudinal and practice behaviors portions of the survey demonstrated preliminary construct validity and test-retest reliability. Regarding advanced care planning, respondents were moderately knowledgeable, but their advanced care planning practice was not routine.
Validly assessing oncology APNs' knowledge, attitudes, and practice behaviors regarding advanced care planning will enable more tailored approaches to improve end-of-life care outcomes.
目的/目标：建立一项基于网络的调查的初始信效度，该调查聚焦于肿瘤学高级实践护士（APN）在临终关怀计划方面的知识、态度和实践行为，并初步了解APN的知识、态度、实践行为以及他们所感知到的临终关怀计划障碍。
描述性、横断面试点调查研究。
美国东部。
300名肿瘤学APN。
以计划行为理论为指导，开发了一份关于知识、态度和实践行为的调查问卷，并对其内容效度进行了审查。该调查问卷通过电子邮件分发给300名APN，并再次发送给最初回复调查的89名APN。采用探索性因素分析来检验该调查中态度和实践行为部分的结构效度和重测信度。
受访者的人口统计学特征、知识、态度、实践行为以及临终关怀计划实践中所感知到的障碍。
探索性因素分析从该调查的态度和实践行为部分得出了一个五因素解决方案，使用克朗巴哈系数进行内部一致性分析。受访者在12项知识部分的平均正确答案率为67%，对临终关怀计划的态度得分呈阳性。他们的实践行为得分略呈阳性。报告的最常见障碍是患者及其家属以及医生不愿讨论临终关怀计划。
该调查的态度和实践行为部分显示出初步的结构效度和重测信度。关于临终关怀计划，受访者有一定的知识，但他们的临终关怀计划实践并不常规。
有效评估肿瘤学APN在临终关怀计划方面的知识、态度和实践行为，将有助于采用更具针对性的方法来改善临终护理结果。
