Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria; Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
Epilepsy Behav. 2019 Feb;91:53-58. doi: 10.1016/j.yebeh.2018.05.004. Epub 2018 May 21.
BACKGROUND/PURPOSE: Some patients perceive the experience of hospitalization in an epilepsy monitoring unit (EMU) to be an uncomfortable one. In order to provide comfort-enhancing measures, nurses need to assess comfort levels. For this purpose, Kolcaba developed the General Comfort Questionnaire (GCQ), which may be modified for usage in specific settings. The objective of this study was to develop an instrument to assess comfort of adult patients during hospitalization in an EMU, namely the Epilepsy Monitoring Unit Comfort Questionnaire (EMUCQ).
The GCQ was translated from American English into German following the guidelines of the International Society for Pharmacoeconomics and Outcome Research (ISPOR). Three native German speakers with good command of the English language did forward translations. An expert who grew up bilingual did a backtranslation. For use in an EMU, literature-based setting-specific items were added. In a qualitative-descriptive study, cognitive debriefing with 25 patients was conducted using cognitive interviews. Qualitative data analysis was based on the framework method. In a quantitative-descriptive study, nine clinical experts assessed content validity.
For setting-specific modification, 12 items pertaining to surroundings, feeling observed, and feeling afraid of a seizure were added to the translated GCQ. Based on the initial content validity rating, 26 items remained unchanged, 12 items underwent revisions, and 14 items were omitted. Eight items were put aside for a follow-up rating in the context of cognitive debriefing. Cognitive interviewing revealed problems regarding the interpretation of items and missing items. According to the results, 27 items remained unchanged, 11 items were reworded, and six items were added. The final content validity rating showed item-content validity indices (I-CVI) between .33 and 1, and an average CVI on a scale level (S-CVI/ave) of .84.
Enhancing comfort is a fundamental nursing goal in demanding situations. Therefore, the contribution of nurses to the quality of individualized patient care is a substantial one. The EMUCQ is a valuable tool to support the assessment of comfort levels. The ISPOR guidelines proved to be useful to ensure high quality of the translated instrument. Using cognitive interviews enhanced the understandability of items and supported modification of the GCQ. At present, S-CVI/ave value of the EMUCQ is acceptable. Further testing is necessary.
背景/目的：一些患者认为在癫痫监测单元（EMU）住院的经历是不舒服的。为了提供舒适的措施，护士需要评估舒适度。为此，Kolcaba 开发了一般舒适度问卷（GCQ），可以对其进行修改以用于特定环境。本研究的目的是开发一种用于评估 EMU 成人患者住院期间舒适度的工具，即癫痫监测单元舒适度问卷（EMUCQ）。
GCQ 按照国际药物经济学和结果研究学会（ISPOR）的指南从美式英语翻译成德语。三位母语为德语且精通英语的人进行了前向翻译。一位双语成长的专家进行了回译。为了在 EMU 中使用，根据文献添加了基于设置的特定项目。在一项定性描述研究中，对 25 名患者进行了认知访谈以进行认知审查。基于框架方法对定性数据进行分析。在一项定量描述研究中，九位临床专家评估了内容的有效性。
对于特定于设置的修改，将与环境、感觉被观察和对癫痫发作感到恐惧有关的 12 个项目添加到翻译后的 GCQ 中。根据初始内容有效性评分，26 个项目保持不变，12 个项目进行了修订，14 个项目被删除。8 个项目被搁置在认知审查的背景下进行后续评分。认知访谈显示出对项目的解释和缺失项目存在问题。根据结果，27 个项目保持不变，11 个项目进行了改写，6 个项目进行了添加。最终的内容有效性评分显示项目内容有效性指数（I-CVI）在.33 到 1 之间，以及尺度水平的平均 CVI（S-CVI/ave）为.84。
在紧张的情况下，增强舒适度是护理的基本目标。因此，护士对患者个性化护理质量的贡献是巨大的。EMUCQ 是一种支持舒适度评估的有用工具。ISPOR 指南证明对确保翻译工具的高质量有用。使用认知访谈提高了项目的可理解性，并支持了 GCQ 的修改。目前，EMUCQ 的 S-CVI/ave 值是可以接受的。还需要进一步的测试。
