Kosteniuk Julie G, Wilson Erin C, Penz Kelly L, MacLeod Martha L P, Stewart Norma J, Kulig Judith C, Karunanayake Chandima P, Kilpatrick Kelley
1Professional Research Associate,Canadian Centre for Health and Safety in Agriculture,University of Saskatchewan,Saskatoon,Saskatchewan,Canada.
2Assistant Professor,School of Nursing,University of Northern British Columbia,Prince George,British Columbia,Canada.
Prim Health Care Res Dev. 2016 Jan;17(1):72-86. doi: 10.1017/S1463423615000158. Epub 2015 Mar 19.
To report the development and psychometric evaluation of a scale to measure rural and remote (rural/remote) nurses' perceptions of the engagement of their workplaces in key dimensions of primary health care (PHC).
Amidst ongoing PHC reforms, a comprehensive instrument is needed to evaluate the degree to which rural/remote health care settings are involved in the key dimensions that characterize PHC delivery, particularly from the perspective of professionals delivering care.
This study followed a three-phase process of instrument development and psychometric evaluation. A literature review and expert consultation informed instrument development in the first phase, followed by an iterative process of content evaluation in the second phase. In the final phase, a pilot survey was undertaken and item discrimination analysis employed to evaluate the internal consistency reliability of each subscale in the preliminary 60-item Primary Health Care Engagement (PHCE) Scale. The 60-item scale was subsequently refined to a 40-item instrument.
The pilot survey sample included 89 nurses in current practice who had experience in rural/remote practice settings. Participants completed either a web-based or paper survey from September to December, 2013. Following item discrimination analysis, the 60-item instrument was refined to a 40-item PHCE Scale consisting of 10 subscales, each including three to five items. Alpha estimates of the 10 refined subscales ranged from 0.61 to 0.83, with seven of the subscales demonstrating acceptable reliability (α ⩾ 0.70). The refined 40-item instrument exhibited good internal consistency reliability (α=0.91). The 40-item PHCE Scale may be considered for use in future studies regardless of locale, to measure the extent to which health care professionals perceive their workplaces to be engaged in key dimensions of PHC.
报告一种量表的开发及心理测量学评估，该量表用于衡量农村和偏远地区（农村/偏远地区）护士对其工作场所参与初级卫生保健（PHC）关键维度情况的认知。
在初级卫生保健改革持续推进的背景下，需要一种综合工具来评估农村/偏远地区医疗保健机构参与初级卫生保健服务关键维度的程度，特别是从提供护理服务的专业人员的角度。
本研究遵循量表开发和心理测量学评估的三个阶段流程。第一阶段通过文献综述和专家咨询为量表开发提供信息，第二阶段进行内容评估的迭代过程。在最后阶段，开展了一项试点调查，并采用项目区分度分析来评估初步的60项初级卫生保健参与度（PHCE）量表中每个子量表的内部一致性信度。随后，将60项量表精简为40项工具。
试点调查样本包括89名目前正在执业且有农村/偏远地区执业经验的护士。参与者在2013年9月至12月期间完成了基于网络或纸质的调查。经过项目区分度分析，60项工具被精简为40项PHCE量表，该量表由10个子量表组成，每个子量表包含三到五个项目。10个精简后的子量表的α系数估计值在0.61至0.83之间，其中7个子量表显示出可接受的信度（α⩾0.70）。精简后的40项工具表现出良好的内部一致性信度（α=0.91）。无论地区如何，未来研究可考虑使用40项PHCE量表来衡量医疗保健专业人员认为其工作场所参与初级卫生保健关键维度的程度。
