Jones Terry L
The University of Texas at Austin, Austin, TX.
Nurs Forum. 2014 Apr-Jun;49(2):77-87. doi: 10.1111/nuf.12076. Epub 2014 Jan 8.
An inverse relationship between implicit rationing and quality patient outcomes has been demonstrated in European hospitals, but this relationship has not been explored in the United States.
To evaluate the psychometric properties of a new measure of implicit rationing, the Perceived Implicit Rationing of Nursing Care (PIRNCA).
A cross-sectional survey design with a stratified random sample of 226 medical surgical nurses was used to evaluate the PIRNCA. The internal structure was evaluated using exploratory factor analysis. Pearson correlations were used to assess the associations between implicit rationing and three related constructs: work environment, overall job satisfaction, and quality of care.
A single-factor solution explaining 55% of the total variance and excellent reliability, Cronbach's alpha = 0.97, was supported for the PIRNCA. Moderate inverse relationships with related constructs provided evidence of concurrent validity: work environment (-0.44), overall job satisfaction (-0.48), and quality of care (-0.56). The majority of nurses (97%) reported rationing at least one of the 30 care activities listed; however, mean scores reflected a low frequency ("rarely") of rationing overall.
The phenomenon of implicit rationing is experienced by nurses in U.S. hospitals, and the PIRNCA instrument is a valid and reliable measure of this phenomenon.
欧洲医院已证实隐性资源分配与优质患者结局之间存在负相关关系，但美国尚未对这种关系进行探讨。
评估一种新的隐性资源分配测量方法——护理感知隐性资源分配量表（PIRNCA）的心理测量特性。
采用横断面调查设计，对226名内科外科护士进行分层随机抽样，以评估PIRNCA。使用探索性因素分析评估内部结构。采用Pearson相关性分析评估隐性资源分配与三个相关结构之间的关联：工作环境、总体工作满意度和护理质量。
PIRNCA支持一个解释总方差55%的单因素解决方案，且具有出色的信度，Cronbach's alpha = 0.97。与相关结构的中度负相关关系为同时效度提供了证据：工作环境（-0.44）、总体工作满意度（-0.48）和护理质量（-0.56）。大多数护士（97%）报告在列出的30项护理活动中至少对其中一项进行了资源分配；然而，平均得分反映出总体资源分配频率较低（“很少”）。
美国医院的护士经历了隐性资源分配现象，PIRNCA工具是对这一现象的有效且可靠的测量方法。
