PhD, RN, Associate Professor, College of Nursing, The Catholic University of Korea, Seoul, ROK.
PhD, RN, Professor, Department of Nursing, Konkuk University, ROK.
J Nurs Res. 2020 Dec;28(6):e120. doi: 10.1097/JNR.0000000000000393.
The concepts of "good nurse" and "better nursing" have changed over time and should be investigated from the perspective of nurses.
The aim of this study was to develop and assess the psychometric properties of two questionnaires used to assess "good nurse" and "better nursing."
The interview data of 30 registered nurses (RNs) from a previous study were reviewed to develop the questionnaire items, and content validity was examined. One hundred seventeen RNs participated in a pilot survey for pretesting the constructs, 469 RNs participated in a main survey to explore these constructs using exploratory factor analysis (EFA), and 468 RNs participated in model refining and validation using confirmatory factor analysis.
After a critical review of RN interview data and content validity evaluation, 73 of 124 statements on "good nurse" and 56 of 57 statements on "better nursing" were selected. In the pilot survey, the number of items was reduced to 45 for both questionnaires using an EFA. In the main survey, EFA was used to load 34 items on the five factors of the good nurse questionnaire and 26 items on the three factors of the better nursing questionnaire. In the confirmatory factor analysis, to obtain better fitting models, the good nurse questionnaire consisted of 17 items on the five factors of collaboration, professional competency, self-efficacy, a sense of achievement, and compassion, whereas the better nursing questionnaire consisted of 16 items on the three factors of person-centered nursing, proactive nursing, and expertise in caring. The construct reliability, convergent validity, and discriminant validity of the questionnaires were achieved.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The concept of "good nurse" from the perspectives of the nurses in this study was similar with those of patients in previous studies, while including individual traits such as sense of achievement. Better nursing is conceptualized with the exemplary performance of nursing focusing on the nature of nursing and leading excellence and power in clinical practice. The study findings inform what nursing education and workforce development should focus on for nursing to continuously progress. Furthermore, it is recommended that the concepts of a good nurse and better nursing be compared across different countries using the questionnaires.
“好护士”和“更好的护理”的概念随着时间的推移而发生了变化，应该从护士的角度进行调查。
本研究旨在开发和评估用于评估“好护士”和“更好的护理”的两个问卷的心理测量学特性。
回顾了 30 名注册护士（RN）的访谈数据，以制定问卷条目，并进行内容效度检查。117 名 RN 参加了预调查以测试结构，469 名 RN 参加了主要调查，使用探索性因素分析（EFA）探讨这些结构，468 名 RN 参加了模型精炼和验证，使用验证性因素分析。
在对 RN 访谈数据进行批判性审查和内容效度评估后，从“好护士”中选择了 124 个语句中的 73 个语句，从“更好的护理”中选择了 57 个语句中的 56 个语句。在预调查中，使用 EFA 将两个问卷的项目数量减少到 45 个。在主要调查中，EFA 将 34 个项目加载到好护士问卷的五个因素上，将 26 个项目加载到更好的护理问卷的三个因素上。在验证性因素分析中，为了获得更好的拟合模型，好护士问卷由合作、专业能力、自我效能、成就感和同情心五个因素的 17 个项目组成，更好的护理问卷由以人为本的护理、主动护理和关怀专业知识三个因素的 16 个项目组成。问卷的结构可靠性、收敛有效性和区分有效性均得到实现。
结论/对实践的启示：从本研究中护士的角度来看，“好护士”的概念与之前研究中的患者相似，但包括成就感等个人特质。更好的护理是通过关注护理的本质并在临床实践中引领卓越和力量来体现护理的卓越表现。研究结果为护理教育和劳动力发展应该关注什么提供了信息，以便护理不断进步。此外，建议使用问卷比较不同国家的好护士和更好的护理概念。
