Zealand University Hospital, Roskilde, Denmark.
University of Southern Denmark, Odense, Denmark.
Worldviews Evid Based Nurs. 2019 Jun;16(3):221-229. doi: 10.1111/wvn.12347. Epub 2019 Jan 28.
Healthcare contexts are rapidly changing, with growing demand for health services to accommodate an aging population and financial pressures. Assessment of context in healthcare settings has been the subject of increasing debate. The Context Assessment Index (CAI) examines three interconnected contextual elements derived from the Promoting Action on Research Implementation in Health Services (PARIHS) framework to provide practitioners with an understanding of the context in which they work.
(a) To describe the translation of the CAI into Danish and adapt the instrument for use in Danish hospitals and (b) to evaluate the psychometric properties of the Danish version of the CAI.
Translation and adaptation included an expert panel and a translation and back-translation process. The CAI was then sent to 4,416 nurses in the Region Zealand, Denmark. There are two alternative measurement models to explain the factor structure of the CAI, the five-factor model and the three-factor model. To provide the best explanation for the data, both measurement models were examined using confirmatory factor analysis.
The CAI was translated and modified based on expert review and usability testing. Completing the CAI were 2,261 nurses. For both models, factor loadings and fit statistics were acceptable, appropriate, and statistically significant, and the measurement models were confirmed (five-factor model: root mean square error of approximation [RMSEA] 0.07, comparative fit index [CFI] = 0.923; three-factor model: RMSEA 0.07, CFI = 0.924). Cronbach's alpha scores showed the models to have broadly acceptable scores (five-factor model 0.64-0.89; three-factor model 0.72-0.89).
The three-factor model can advantageously be used when the PARIHS framework is part of the project. In a translation process, differences in cultural specificity, language, and working environment have to be considered. By understanding the context of practice, nurses may enable person-centered care and improve patient outcomes.
医疗保健环境正在迅速变化，对医疗服务的需求不断增长，以适应人口老龄化和财政压力。对医疗保健环境中的背景进行评估已成为越来越多的争论主题。Context Assessment Index（CAI）检查了源自 Promoting Action on Research Implementation in Health Services（PARIHS）框架的三个相互关联的上下文元素，为从业者提供了对其工作环境的理解。
（a）将 CAI 翻译成丹麦语，并对该工具进行改编，使其适用于丹麦医院；（b）评估 CAI 丹麦版本的心理测量学特性。
翻译和改编包括专家小组和翻译及回译过程。然后，将 CAI 发送给丹麦西兰大区的 4416 名护士。有两种替代的测量模型可以解释 CAI 的因子结构，即五因子模型和三因子模型。为了为数据提供最佳解释，使用验证性因子分析检验了这两种测量模型。
CAI 根据专家审查和可用性测试进行了翻译和修改。有 2261 名护士完成了 CAI。对于这两种模型，因子负荷和拟合统计数据都是可以接受的、适当的和统计学显著的，并且测量模型得到了确认（五因子模型：近似均方根误差[RMSEA]0.07，拟合指数[CFI]0.923；三因子模型：RMSEA 0.07，CFI 0.924）。Cronbach's alpha 分数表明这两种模型的分数都具有广泛的可接受性（五因子模型 0.64-0.89；三因子模型 0.72-0.89）。
当 PARIHS 框架是项目的一部分时，三因子模型可以有利地使用。在翻译过程中，必须考虑文化特异性、语言和工作环境的差异。通过了解实践背景，护士可以提供以人为本的护理，并改善患者的结果。
