Beitz Janice M, Colwell Janice C
Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN, CRNP, MAPWCA, FAAN, Professor of Nursing, WOCNEP Director, School of Nursing-Camden, Rutgers University, Camden, New Jersey. Janice C. Colwell, RN, MS, CWOCN, FAAN, Clinical Specialist, WOC Nursing, University of Chicago Medicine, Chicago, Illinois.
J Wound Ostomy Continence Nurs. 2014 Sep-Oct;41(5):445-54. doi: 10.1097/WON.0000000000000052.
The objectives of this study were to establish additional content validation data for proposed stomal and peristomal complications interventions and to identify optimal interventions for the specified complications based on experts' clinical judgment.
Following pilot testing of the researcher-designed instrument, the survey was mailed to 1000 systematically randomly selected expert WOC nurses via a national mailing to a representative sample of participants who identified in their WOCN Society description as having ostomy certification and/or clinical expertise. Two hundred eighty-one nurses returned the survey, comprising a response rate of 28%.
A cross-sectional, quantitative descriptive design with qualitative components was used for this study. Respondents were asked to quantify degree of validity (relevance or appropriateness) of the survey's stated stomal and peristomal complications interventions. They were asked to rank interventions for each stomal and peristomal complication for being first-line (most preferred), second-line, and third-line treatment. Hand-written qualitative comments of the participants were transcribed and analyzed, and themes were derived.
On a scale of 1 to 4, the mean score for all interventions was 3.47 ± 0.29 (relevant/very relevant, mean ± SD). The overall survey's Content Validity Index was 0.84 out of 1.00. Some items had lower mean scores and content validity index scores, especially peristomal interventions. Ranking of most preferred treatments revealed clearly preferred approaches in some clinical situations and some less so. Qualitative analysis of participants' comments about each stomal and peristomal complication intervention and about the whole instrument and research process was conducted generating positive and negative themes.
The proposed stomal and peristomal interventions were rated as generally valid substantiating results of our earlier study. The ranking of most preferred treatments for stomal and peristomal complications provides, to the authors' knowledge, the world's first research support for prioritized approaches and evidence-based practice in ostomy care.
本研究的目的是为拟议的造口及造口周围并发症干预措施建立更多的内容效度数据，并根据专家的临床判断确定针对特定并发症的最佳干预措施。
在对研究人员设计的工具进行预试验后，通过全国性邮寄向1000名系统随机抽取的专家级伤口造口失禁护理（WOC）护士发送了调查问卷，这些护士是从伤口造口失禁护理协会描述中确定为具有造口认证和/或临床专业知识的代表性参与者样本中选取的。281名护士回复了调查问卷，回复率为28%。
本研究采用了带有定性成分的横断面定量描述性设计。要求受访者对调查问卷中所述的造口及造口周围并发症干预措施的效度（相关性或适宜性）程度进行量化。要求他们对每种造口及造口周围并发症的干预措施按一线（最优选）、二线和三线治疗进行排序。对参与者手写的定性评论进行转录和分析，并得出主题。
在1至4的量表上，所有干预措施的平均得分为3.47±0.29（相关/非常相关，平均值±标准差）。整个调查问卷的内容效度指数为0.84（满分1.00）。一些项目的平均得分和内容效度指数得分较低，尤其是造口周围干预措施。对最优选治疗方法的排序显示，在某些临床情况下有明显优选的方法，而在某些情况下则不然。对参与者关于每种造口及造口周围并发症干预措施以及整个工具和研究过程的评论进行了定性分析，得出了积极和消极的主题。
拟议的造口及造口周围干预措施被评定为总体有效，证实了我们早期研究的结果。据作者所知，对造口及造口周围并发症最优选治疗方法的排序为造口护理中优先方法和循证实践提供了世界上首个研究支持。
