探索医院对初级护理模式的依从性：运用德尔菲法验证一份量表。

Exploring hospital compliance with the primary nursing care model: validating an inventory using the Delphi method.

作者信息

Cocchieri Antonello, Magon Giorgio, Cavalletti Manuela, Cristofori Elena, Zega Maurizio

机构信息

Fondazione Policlinico A. Gemelli IRCCS, 00168, Rome, Italy.

Section of Hygiene, Woman and Child Health and Public health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.

出版信息

BMC Nurs. 2021 Oct 4;20(1):188. doi: 10.1186/s12912-021-00712-1.

DOI:10.1186/s12912-021-00712-1

PMID:34607579

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8491371/

Abstract

BACKGROUND

The primary nursing care model is considered a personalized model of care delivery based on care continuity and on the relationship between the nurse and patient. Primary nursing checklists are not often mentioned in the literature; however, they represent a valid instrument to develop, implement, and evaluate primary nursing. The aim of this study was to create a structured checklist to explore hospital compliance in primary nursing.

METHODS

The Delphi method was used to develop and validate a checklist. The preliminary version was created and sent to three experts for their opinions. Their comments were ultimately used in the first version, which included four components with 19 items regarding primary nursing characteristics. A two-round Delphi process was used to generate consensus items. The Delphi panel consisted of six experts working in primary nursing contexts and/or teaching or studying primary nursing. Data were collected using a structured questionnaire from July 2020 to January 2021. These experts were asked to rate each element for relevance using a 4-point Likert-type scale. Furthermore, the consensus among the panel of experts was set at ≥78%, with selected items being voted "quite relevant" and "highly relevant". Content validity index (I-CVI) and modified kappa statistic were also calculated. Following expert evaluation, the first version of the checklist was modified, and the new version, constituting 17 items, was sent to the same experts.

RESULTS

The first version of the checklist demonstrated a main relevance score of 3.34 (SD = 0.83; range = 1.3-4; mean I-CVI = 0.84; range: 0.83-1), but three items did not receive an adequate I-CVI score, that is, lower than 0.78. After the second round, the I-CVIs improved. The main score of relevance was 3.61 (SD: 0.35; range = 2.83-4; mean = I-CVI: 0.93). The S-CVI/UA was 0.58, and the S-CVI/Ave was 0.93.

CONCLUSION

Measuring primary nursing compliance should be implemented to provide continuous feedback to nurses. Moreover, utilizing valid checklists could permit comparing different results from others' research. Future research should be conducted to compare the results from the checklist with nursing outcomes.

摘要

背景

初级护理模式被认为是一种基于护理连续性以及护士与患者关系的个性化护理模式。初级护理清单在文献中并不常被提及；然而，它们是制定、实施和评估初级护理的有效工具。本研究的目的是创建一个结构化清单，以探索医院在初级护理方面的合规情况。

方法

采用德尔菲法来制定和验证清单。创建了初步版本并发送给三位专家征求意见。他们的意见最终被用于第一个版本，该版本包括四个部分，共19项关于初级护理特征的内容。采用两轮德尔菲法来达成共识项目。德尔菲小组由六位从事初级护理工作和/或教授或研究初级护理的专家组成。2020年7月至2021年1月期间，使用结构化问卷收集数据。要求这些专家使用4点李克特量表对每个要素的相关性进行评分。此外，专家小组的共识设定为≥78%，被选中的项目被评为“相当相关”和“高度相关”。还计算了内容效度指数（I-CVI）和修正卡帕统计量。经过专家评估，对清单的第一个版本进行了修改，并将由17项组成的新版本发送给相同的专家。

结果

清单的第一个版本显示主要相关性得分为3.34（标准差=0.83；范围=1.3 - 4；平均I-CVI = 0.84；范围：0.83 - 1），但有三个项目的I-CVI得分不足，即低于下限0.78。第二轮之后，I-CVI有所提高。主要相关性得分为3.61（标准差：0.35；范围=2.83 - 4；平均=I-CVI：0.93）。S-CVI/UA为0.58，S-CVI/Ave为0.93。