中国肺癌术前患者护理缺失工具的开发与验证
Development and Validation of the Missed Nursing Care Tool for Pre-Operative Patients with Lung Cancer in China.
作者信息
Shi Xin-Ping, Dychangco Ma Encarnacion A, Yang Xu-Ming, Olivar Jennifer Joy R
机构信息
The Nursing Department, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
Paulinian Leadership Academy, University Research Council, St Paul University Manila, Manila, Philippine.
出版信息
Patient Prefer Adherence. 2023 Jun 17;17:1451-1465. doi: 10.2147/PPA.S413585. eCollection 2023.
INTRODUCTION
Current research suggests that missed nursing care is widespread in preoperative lung cancer patients in China, and preoperative airway management nursing care for lung cancer patients is not standardized. Missed nursing care for preoperative lung cancer patients, on the other hand, is rarely investigated, particularly from the patient's perspective. This study aimed to develop and validate the MISSCARE Survey for pre-operative patients with lung cancer in China.
METHODS
This study generated the preliminary draft of the MISSCARE Survey - Lung Cancer Patient (MS-LCP) and tested its reliability and stability through three rounds of lung cancer resection (494, 50, and 309 cases, respectively). 20 patients and 6 experts determined the face and content validity. EFA and CFA assessed construct and convergent validity. Internal consistency, including Cronbach's alpha, Spearman-Brown reliability, and re-test reliability, was also examined.
RESULTS
The scale contained 15 items, including specific care, communicative care, timely care, and basic care. KMO was 0.932 (> 0.6), and Bartlett's Test of Sphericity showed P = 0.000 (<0.05). The attribution factor's item loads ranged from 0.765 to 0.853, accounting for 82.20% of the variation. The scale's Cronbach's alpha, Spearman-Brown, and retest reliability were 0.945, 0.879, and 0.824. CFA showed goodness of fit (RMSEA = 0.021, /df = 1.138, GFI = 0.900, AGFI = 0.945, CFI = 0.996, NFI = 0.967, IFI = 0.996). For each dimension, AVE ranged from 0.555 to 0.717 (>0.50) and CR from 0.861 to 0.904 (>0.70).
CONCLUSION
The MS-LCP was reliable and valid in this study, making it appropriate for the Chinese lung cancer patient population. This tool is more objective in its presentation of missed nursing care, assisting nursing staff in optimizing nursing procedures before surgery, increasing the implementation of higher-quality tumor care, and promoting the recovery of lung cancer surgery patients.
引言
当前研究表明，在中国，术前肺癌患者中护理缺失情况普遍存在，且肺癌患者的术前气道管理护理并不规范。另一方面，针对术前肺癌患者护理缺失情况的研究较少，尤其是从患者角度进行的研究。本研究旨在开发并验证适用于中国术前肺癌患者的护理缺失情况调查问卷（MISSCARE Survey）。
方法
本研究生成了肺癌患者护理缺失情况调查问卷（MS-LCP）的初稿，并通过三轮肺癌切除术（分别为494例、50例和309例）对其信度和稳定性进行了测试。20名患者和6名专家确定了该问卷的表面效度和内容效度。采用探索性因子分析（EFA）和验证性因子分析（CFA）评估结构效度和收敛效度。还检验了内部一致性，包括克朗巴哈系数（Cronbach's alpha）、斯皮尔曼-布朗信度（Spearman-Brown reliability）和重测信度。
结果
该量表包含15个条目，包括特殊护理、沟通护理、及时护理和基础护理。Kaiser-Meyer-Olkin（KMO）值为0.932（>0.6），巴特利特球形检验显示P = 0.000（<0.05）。各归因因子的项目载荷范围为0.765至0.853，解释了82.20%的变异。该量表的克朗巴哈系数、斯皮尔曼-布朗信度和重测信度分别为0.945、0.879和0.824。验证性因子分析显示模型拟合良好（RMSEA = 0.021，χ²/df = 1.138，GFI = 0.900，AGFI = 0.945，CFI = 0.996，NFI = 0.967，IFI = 0.996）。对于每个维度，AVE范围为0.555至0.717（>0.50），CR范围为0.861至0.904（>0.70）。
结论
本研究中MS-LCP具有可靠性和有效性，适用于中国肺癌患者群体。该工具在呈现护理缺失情况方面更为客观，有助于护理人员优化术前护理流程，提高高质量肿瘤护理的实施水平，并促进肺癌手术患者的康复。
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