Gattinger Heidrun, Leino-Kilpi Helena, Hantikainen Virpi, Köpke Sascha, Ott Stefan, Senn Beate
Department of Nursing Science, University of Turku, Turku, Finland ; Institute of Applied Nursing Science, FHS St. Gallen University of Applied Sciences, Rosenbergstrasse 59, 9001 St. Gallen, Switzerland.
Department of Nursing Science, University of Turku, Turku, Finland ; Turku University Hospital, Turku, Finland.
BMC Nurs. 2016 Nov 22;15:65. doi: 10.1186/s12912-016-0185-z. eCollection 2016.
Between 75 and 89% of residents living in long-term care facilities have limited mobility. Nurses as well as other licensed and unlicensed personnel directly involved in resident care are in a key position to promote and maintain the mobility of care-dependent persons. This requires a certain level of competence. Kinaesthetics is a training concept used to increase nursing staff's interaction and movement support skills for assisting care-dependent persons in their daily activities. This study aims to develop and test an observation instrument for assessing nursing staff's competences in kinaesthetics.
The Kinaesthetics Competence (KC) observation instrument was developed between January and June 2015 based on a literature review, a concept analysis and expert meetings (18). The pilot instrument was evaluated with two expert panels ( = 5, = 4) regarding content validity, usability and inter-rater agreement. Content validity was assessed by determining the content validity index (CVI). The final instrument was tested in a cross-sectional study in three nursing homes in the German-speaking part of Switzerland between July 2015 and February 2016. In this study nursing staff ( = 48) was filmed during mobilization situations. Based on this video data two observers independently assessed nursing staff's competences in kinaesthetics with the KC observation instrument. Inter-rater reliability and inter-rater agreement was evaluated using the intra-class correlation coefficient (ICC) and percentage of agreement. Construct validity was assessed by a discriminating power analysis. Internal consistency was evaluated using Cronbach's alpha coefficient and item analysis.
The final version of the KC observation instrument comprised of four domains (interaction, movement support of the person, nurses' movement, environment) and 12 items. The final instrument showed an excellent content validity index of 1.0. Video sequences from 40 persons were analysed. Inter-rater reliability for the whole scale was good (ICC 0.73) and the percentage of inter-rater agreement was 53.6% on average. Cronbach's alpha coefficient for the whole instrument was 0.97 and item-total correlations ranged from 0.76 to 0.90. The construct validity of the instrument was supported by a significant discrimination of the instrument between nursing staff with no or basic and with advanced kinaesthetics training for the total score and 3 of 4 subscales.
The KC observation instrument showed good preliminary psychometric properties and can be used to assess nursing staff's competences in mobility care based on the principles of kinaesthetics.
居住在长期护理机构中的居民，75%至89%行动不便。护士以及其他直接参与居民护理的持牌和无牌人员，在促进和维持依赖护理者的行动能力方面处于关键地位。这需要一定水平的能力。动觉是一种培训理念，用于提高护理人员在协助依赖护理者进行日常活动时的互动和移动支持技能。本研究旨在开发并测试一种用于评估护理人员动觉能力的观察工具。
基于文献综述、概念分析和专家会议（18），于2015年1月至6月期间开发了动觉能力（KC）观察工具。该试点工具由两个专家小组（分别为5人和4人）就内容效度、可用性和评分者间一致性进行评估。通过确定内容效度指数（CVI）来评估内容效度。最终工具于2015年7月至2016年2月期间在瑞士德语区的三家养老院进行的横断面研究中进行测试。在这项研究中，护理人员（n = 48）在协助居民活动的场景中被拍摄下来。基于这些视频数据，两名观察者使用KC观察工具独立评估护理人员的动觉能力。使用组内相关系数（ICC）和一致性百分比评估评分者间信度和评分者间一致性。通过区分力分析评估结构效度。使用克朗巴赫α系数和项目分析评估内部一致性。
KC观察工具的最终版本包括四个领域（互动、对居民的移动支持、护士的移动、环境）和12个项目。最终工具显示出优异的内容效度指数1.0。分析了40人的视频片段。整个量表的评分者间信度良好（ICC 0.73），评分者间一致性百分比平均为53.6%。整个工具的克朗巴赫α系数为0.97，项目与总分的相关性范围为0.76至0.90。该工具的结构效度得到支持，因为在总分以及4个分量表中的3个分量表上，该工具对未接受或仅接受基础动觉培训的护理人员与接受高级动觉培训的护理人员之间有显著区分。
KC观察工具显示出良好的初步心理测量特性，可用于根据动觉原则评估护理人员在移动护理方面的能力。
