Laura Sinko, PhD, RN, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA.
Dana Beck, BA, BSN, RN, FNP-BC, University of Michigan School of Nursing, Ann Arbor, MI, USA.
J Am Psychiatr Nurses Assoc. 2022 Nov-Dec;28(6):455-463. doi: 10.1177/1078390320970652. Epub 2020 Nov 9.
Service delivery organizations are advancing the provision of trauma-informed care (TIC) for youth to improve outcomes. However, currently there are no validated, reliable evaluation measures to capture the voices of adolescent clients and how well they perceive TIC implementation.
The purpose of this project was to create an evaluation measure with strong content validity for adolescent health and service users to give feedback to organizations about their implementation of TIC. This article outlines Step 1 of our instrument development, by discussing our process creating the measure and affirming content validity. Psychometric testing of this measure (Step 2) is described in a companion paper.
We combined deductive theory substruction with an inductive participatory process to create, revise, and finalize the measure. The National Center for Trauma-Informed Care's framework of four practices and six principles was substructed into an 18-item draft measure. A four-member community youth advisory board (CYAB) then worked to inductively modify our draft to provide age-appropriate clarity and ensure a nontriggering respondent experience. Finally, the CYAB members conducted cognitive interviews with 10 other adolescents in local evening data collection events, refining the measure for future psychometric testing.
The process resulted in a 20-item form based on CYAB feedback. Refinements included providing an accessible definition of trauma, asking questions about trauma history, and asking whether trauma affected the client's visit on the day of service use.
The CYAB involvement enhanced content validity and ensured a trauma-informed instrument development approach.
服务提供机构正在推进为青少年提供创伤知情护理（TIC），以改善治疗效果。然而，目前还没有经过验证、可靠的评估措施来捕捉青少年客户的意见以及他们对 TIC 实施的看法。
本项目的目的是创建一个具有较强内容效度的青少年健康和服务使用者评估工具，以便组织能够就其 TIC 实施情况提供反馈。本文概述了我们仪器开发的第 1 步，讨论了我们创建该测量工具的过程，并确认了其内容效度。该测量工具的心理测量学测试（第 2 步）在一篇配套论文中进行了描述。
我们将演绎理论构建与归纳参与性过程相结合，以创建、修改和最终确定该测量工具。国家创伤知情护理中心的四项实践和六项原则框架被构建到一个 18 项的草案中。然后，由四名社区青年顾问委员会（CYAB）成员进行归纳性修改，以提供适合年龄的清晰度，并确保受访者的体验不会受到创伤。最后，CYAB 成员在当地晚间数据收集活动中对另外 10 名青少年进行了认知访谈，进一步完善了该测量工具，以便在未来进行心理测量学测试。
这一过程基于 CYAB 的反馈得出了一个 20 项的表格。改进包括提供创伤的可访问定义，询问创伤史问题，并询问创伤是否影响客户在服务使用当天的就诊。
CYAB 的参与提高了内容效度，并确保了以创伤知情的方式进行仪器开发。
