Clinical Research Utilization (CRU), Karolinska University Hospital, Stockholm, Sweden.
Worldviews Evid Based Nurs. 2013 Feb;10(1):41-50. doi: 10.1111/j.1741-6787.2012.00252.x. Epub 2012 May 30.
The strength of and relationship between the fundamental elements context, evidence and facilitation of the PARIHS framework are proposed to be key for successful implementation of evidence into healthcare practice. A better understanding of the presence and strength of contextual factors is assumed to enhance the opportunities of adequately developing an implementation strategy for a specific setting. A tool for assessing context-The Context Assessment Index (CAI)-was developed and published 2009. A Swedish version of the instrument was developed and evaluated among registered nurses. This work forms the focus of this paper.
The purpose of this study was to translate the CAI into Swedish, adapt the instrument for use in Swedish healthcare practice and assess its psychometric properties.
The instrument was translated and back-translated to English. The feasibility of items and response scales were evaluated through think aloud interviews with clinically active nurses. Psychometric properties were evaluated in a sample of registered nurses (n = 373) working in a variety of healthcare organisations in the Stockholm area. Item and factor analyses and Cronbach's alpha were computed to evaluate internal structure and internal consistency.
Sixteen items were modified based on the think aloud interviews and to adapt the instrument for use in acute care. A ceiling effect was observed for many items and the originally identified 37 item five-factor model was not confirmed. Item analyses showed an overlap between factors and indicated a one-dimensional scale.
The Swedish version of the CAI has a wider application than the original instrument. This might have contributed to the differences in factor structure. Different opportunities for further development of the scale are discussed.
Further evaluation of the psychometric properties of the CAI is required.
PARIHS 框架的基本要素——背景、证据和促进因素的强度和关系，被认为是将证据成功应用于医疗实践的关键。更好地了解背景因素的存在和强度，有望增加为特定环境充分制定实施策略的机会。为了评估背景，开发了一种工具——上下文评估指数（CAI）——并于 2009 年发布。该工具的瑞典语版本已经开发并在注册护士中进行了评估。这项工作是本文的重点。
本研究旨在将 CAI 翻译成瑞典语，使该工具适应瑞典的医疗保健实践，并评估其心理测量特性。
对该工具进行翻译和回译。通过与临床活跃护士进行出声思考访谈，评估项目和反应量表的可行性。在斯德哥尔摩地区的各种医疗保健组织中工作的注册护士（n=373）样本中评估心理测量特性。计算项目和因子分析以及克朗巴赫的 alpha 来评估内部结构和内部一致性。
根据出声思考访谈，对 16 个项目进行了修改，并对该工具进行了改编，以适应急性护理。许多项目都出现了上限效应，最初确定的 37 项五因素模型没有得到证实。项目分析表明因素之间存在重叠，并表明存在一维量表。
CAI 的瑞典语版本比原始版本具有更广泛的应用。这可能导致因子结构的差异。讨论了进一步开发该量表的不同机会。
需要进一步评估 CAI 的心理测量特性。
