Mok Wenqi, Wang Wenru, Cooper Simon, Ang Emily Neo Kim, Liaw Sok Ying
Khoo Teck Puat Hospital, Singapore 768828, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Int J Qual Health Care. 2015 Jun;27(3):207-13. doi: 10.1093/intqhc/mzv019. Epub 2015 Apr 16.
To develop and determine the psychometrics properties of an instrument (V-scale) and to explore nurses' attitudes towards vital signs monitoring in the detection of clinical deterioration in general wards.
Scale development with psychometric testing and a descriptive quantitative survey.
Tertiary acute care hospital.
A total of 614 general ward nurses.
Principal component analysis revealed a 16-item instrument in a five-factor solution (key indicators, knowledge, communication, workload and technology) that explained 56.27% of the variance. The internal consistency was sufficient with Cronbach's alpha of 0.71 and strong item subscale correlations (0.56-0.89). The test-retest reliability was adequate with an Intraclass Correlation Coefficient (ICC) of 0.85. Many nurses (56.9%) erroneously perceived blood pressure changes as the first indicator of deterioration, and 46% agreed that an altered respiratory rate was the least important indicator. Most nurses (59.8%) also reported relying on oxygen saturation to evaluate respiratory dysfunction, and 27.4% indicated that they make quick estimates of the respiratory rate. Current practices for vital signs monitoring were considered to be time consuming (21.0%) and overwhelming (35.3%). Nurses' attitudes were most significantly influenced by whether they had a degree qualification followed by whether they worked in a general ward with a specialty and had >5 years of experience.
This exploratory study provides evidence for the psychometric properties of the V-scale. It reveals a need for continuous professional development to improve ward nurses' attitudes towards vital signs monitoring. Vital signs monitoring needs to be prioritized in workload planning.
开发并确定一种工具（V量表）的心理测量学特性，并探讨护士在普通病房临床病情恶化检测中对生命体征监测的态度。
进行心理测量测试的量表开发及描述性定量调查。
三级急症医院。
共614名普通病房护士。
主成分分析显示，在一个五因素解决方案（关键指标、知识、沟通、工作量和技术）中有一个包含16个条目的工具，该工具解释了56.27%的方差。内部一致性良好，Cronbach's alpha系数为0.71，且条目与子量表的相关性较强（0.56 - 0.89）。重测信度足够，组内相关系数（ICC）为0.85。许多护士（56.9%）错误地将血压变化视为病情恶化的首要指标，46%的护士认为呼吸频率改变是最不重要的指标。大多数护士（59.8%）还报告依靠血氧饱和度来评估呼吸功能障碍，27.4%的护士表示他们会快速估算呼吸频率。目前生命体征监测的做法被认为耗时（21.0%）且任务繁重（35.3%）。护士的态度受其是否拥有学位资格影响最大，其次是是否在设有专科的普通病房工作且拥有超过5年工作经验。
这项探索性研究为V量表的心理测量学特性提供了证据。它揭示了需要持续的专业发展来改善病房护士对生命体征监测的态度。在工作量规划中，生命体征监测需要被优先考虑。
