Fernández-Domínguez Juan Carlos, de Pedro-Gómez Joan Ernest, Morales-Asencio José Miguel, Bennasar-Veny Miquel, Sastre-Fullana Pedro, Sesé-Abad Albert
Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Balearic Islands, Spain.
Department of Nursing, Faculty of Health Sciences, University of Malaga, Andalucía, Spain.
PLoS One. 2017 May 9;12(5):e0177172. doi: 10.1371/journal.pone.0177172. eCollection 2017.
Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals.
A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach's alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19).
Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity.
Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The tool could be useful for EBP individual assessment and for evaluating the impact of specific interventions to improve EBP.
如文献综述所示，迄今为止可用的大多数循证实践测量工具在构念的操作化以及心理测量学发展的严谨性方面都存在局限性。本文旨在为一种新的跨学科心理测量工具——健康科学循证实践（HS-EBP）的得分提供严格且充分的信效度证据，该工具用于测量健康科学专业人员的循证实践构念。
进行了一项预试验研究以及后续的两阶段验证测试样本，以逐步完善该工具，直至形成一个简化的60项版本且具有五因素潜在结构。通过Cronbach's α系数和组内相关系数（ICC）分析信度。采用模型比较方法，通过验证性因素分析（CFA）对比潜在结构。通过将对变革的态度抗性、职业倦怠和职业生活质量作为标准变量，来获得所得分数的效标效度证据；同时使用循证实践问卷（EBPQ-19）的西班牙语版本评估聚合效度。
问卷的五个维度均获得了充分的信度和ICC证据。根据CFA模型比较，最佳拟合对应五因素模型（RMSEA = 0.049；90%置信区间RMSEA = [0.047；0.050]；CFI = 0.99）。还提供了充分的效标效度和聚合效度证据。最后，HS-EBP显示出能够发现循证实践培训水平之间的差异，这是决策效度的重要证据。
关于HS-EBP获得的信效度证据证实了循证实践构念作为一种在健康科学专业人员（跨专业）日常实践中应对各种临床情况而实施的过程的充分操作性。该工具可用于循证实践的个体评估以及评估改善循证实践的特定干预措施的影响。
