Department of Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Aust Crit Care. 2023 Jul;36(4):455-463. doi: 10.1016/j.aucc.2022.03.011. Epub 2022 May 18.
Delirium in patients in the intensive care unit is associated with adverse outcomes. Nurses experience many difficulties in caring for those with delirium, which can lead to nurse burnout, prevent effective care for patients, and negatively impact the patient. The identification of factors creating challenges for nurses is, therefore, important to enable intervention.
The aim of this study was to develop a new scale to assess the difficulties faced by nurses caring for patients with delirium in the intensive care unit and to examine its reliability and validity.
We based our draft scale items on literature reviews and interviews. Four experts evaluated the collected items. After a pilot study, 211 nurses working in intensive care units in Japan completed the questionnaire. Subsequent statistical analysis of results included factor validity, construct validity, known-group validity, internal consistency, and test-retest reliability.
Exploratory factor analysis extracted a scale of 33 items with eight factors and an additional scale of four items with one factor. The analysis of construct validity suggested a possible association with the Strain of Care for Delirium Index. In the known-group validity, a comparison with two groups based on experience in the intensive care unit found significant differences among the five factors. Internal consistency (Cronbach's α = 0.68-.87) and test-retest reliability (intraclass correlation coefficients = .46-.62) were confirmed.
We developed a difficulty scale for nurses caring for patients with delirium in the intensive care unit and confirmed its reliability and validity. The difficulty factors were developed with the intention to identify educational interventions for nurses and the introduction of new organisational resources, such as manpower and providing emotional support and feedback to nurses.
重症监护病房患者的谵妄与不良结局相关。护士在护理谵妄患者时会遇到很多困难，这可能导致护士倦怠，妨碍对患者的有效护理，并对患者产生负面影响。因此，确定给护士带来挑战的因素对于实施干预措施很重要。
本研究旨在开发一种新的量表来评估重症监护病房护士在护理谵妄患者时所面临的困难，并检验其信度和效度。
我们基于文献回顾和访谈制定了量表条目草案。四位专家对收集到的条目进行了评估。在预试验后，日本 211 名重症监护病房护士完成了问卷。随后对结果进行了因子有效性、结构有效性、已知组有效性、内部一致性和重测信度的统计分析。
探索性因子分析提取了一个由 33 个条目、8 个因子组成的量表和一个由 4 个条目、1 个因子组成的附加量表。结构有效性分析表明，该量表可能与“护理谵妄量表的压力”存在关联。在已知组有效性方面，与两组根据在重症监护病房的经验进行比较，五个因子之间存在显著差异。内部一致性（克朗巴赫 α=0.68-0.87）和重测信度（组内相关系数=0.46-0.62）得到了确认。
我们开发了一种重症监护病房护士护理谵妄患者的困难量表，并验证了其信度和效度。这些困难因素的确定旨在为护士确定教育干预措施，并引入新的组织资源，如人力，并为护士提供情感支持和反馈。
