Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA.
J Nurs Scholarsh. 2011 Dec;43(4):405-11. doi: 10.1111/j.1547-5069.2011.01420.x. Epub 2011 Oct 21.
To conduct psychometric testing of an instrument, the Smoking Cessation Counseling (SCC) Scale, to measure evidence-based smoking cessation counseling interventions by nurses.
A cross-sectional study was conducted using a written Teleform survey, administered to Registered Nurses (N = 591) from 23 rural hospitals in the eastern United States.
The SCC scale was developed from the U.S. Department of Health and Human Services guidelines for nurses. The survey includes 26 items, with 24 using a four-level response format indicating the extent to which the nurse implements each item (not at all, less than half the time, more than half the time, and all of the time). The total SCC score was computed for 24 items. Two additional items assess comfort in smoking cessation counseling skill and comfort in referral to resources and use a 10-point response format (1 = not at all comfortable to 10 = very comfortable). Reliability statistics for consistency of item measures were estimated using a two-way mixed model in which respondent effects were random and measures effects were fixed. The validity of the instrument was measured in the following ways: (a) total SCC score was correlated with overall comfort in smoking cessation counseling; (b) regression model was conducted for the total SCC score and comfort in smoking cessation counseling skills adjusted for demographic variables (education, gender, age, ethnicity); and (c) exploratory factor analysis on the item scale data to see if the scale was unidimensional or could be split into several subscales and independent components or factors.
The estimated Cronbach's α intraclass correlation coefficient of 24 items for reliability was 0.955, indicating high internal consistency. The total SCC score is strongly positively correlated with comfort in smoking cessation counseling. Using exploratory factor analysis, four factors were extracted from 24 items that explained 68.3% of SCC score variation. The first factor explained 48.9% of variation representing an advanced SCC activity component. The second, third, and fourth extracted factors representing regulatory, referral, and basic components together explained 19.4% of SCC score variation.
Psychometric testing supports that the SCC is reliable (internally consistent) and valid for representing nursing compliance with evidence-based smoking cessation counseling. The extracted independent factors resulting from factor analysis can be used for investigating the impact of the SCC on patient outcomes.
The SCC can be used by researchers or nurses in practice who are interested in assessing, improving, or testing evidence-based practices for smoking cessation counseling.
对一种测量护士实施基于证据的戒烟咨询干预的工具——戒烟咨询量表（SCC）进行心理计量学测试。
本研究采用横断面研究，使用书面 Teleform 调查，对美国东部 23 家农村医院的注册护士（N=591）进行调查。
SCC 量表是根据美国卫生与公众服务部为护士制定的指南开发的。该调查包括 26 个项目，其中 24 个项目采用四级反应格式，用以表示护士实施每个项目的程度（完全不、不到一半时间、超过一半时间、全部时间）。24 个项目的 SCC 总分计算。另外两个项目评估对戒烟咨询技能的舒适程度和对资源转介的舒适程度，采用 10 分制（1=非常不舒适，10=非常舒适）。使用双向混合模型估计项目测量一致性的可靠性统计数据，其中受访者效应是随机的，测量效应是固定的。通过以下方式测量工具的有效性：（a）SCC 总分与整体戒烟咨询舒适度相关；（b）对总 SCC 评分和戒烟咨询技能舒适度进行回归模型分析，调整人口统计学变量（教育、性别、年龄、种族）；（c）对项目量表数据进行探索性因子分析，以确定量表是否为单维的，或者是否可以分为几个亚量表和独立成分或因子。
24 个项目的估计 Cronbach's α 内部一致性信度 ICC 为 0.955，表明内部一致性高。SCC 总分与戒烟咨询舒适度呈强正相关。使用探索性因子分析，从 24 个项目中提取出 4 个因子，解释了 SCC 评分变化的 68.3%。第一个因子解释了 48.9%的变化，代表了高级 SCC 活动成分。提取的第二、第三和第四个因子代表监管、转介和基本成分，共同解释了 SCC 评分变化的 19.4%。
心理计量学测试支持 SCC 具有可靠性（内部一致性）和有效性，可代表护理人员对基于证据的戒烟咨询的依从性。因子分析得出的独立因子可用于研究 SCC 对患者结局的影响。
SCC 可被对评估、改善或测试基于证据的戒烟咨询实践感兴趣的研究人员或临床护士使用。
