From the Institute for Teaching and Learning, Ritsumeikan University, Kyoto.
Faculty of Nursing and Welfare, Reiwa Health Sciences University, Fukuoka.
J Patient Saf. 2023 Dec 1;19(8):564-572. doi: 10.1097/PTS.0000000000001162. Epub 2023 Oct 17.
Disruptive clinician behavior worsens communication, information transfer, and teamwork, all of which negatively affect patient safety. Improving safety in medical care requires an accurate assessment of the damage caused by disruptive clinician behavior. Psychometric scales complement case reports, but existing scales have significant limitations. Therefore, this study developed a psychometric scale based on the psychological paradigm to assess disruptive clinician behavior.
The scale was developed through a sequence of steps. First, we used an open-ended questionnaire targeting 712 nurses, content analysis, and content validity assessment by 5 experts to determine valid items for disruptive clinical behavior. Next, an Internet questionnaire survey targeting 1000 health care staff, exploratory factor analysis, and subfactor analysis was conducted to identify necessary and sufficient factors. Then, we calculated difficulty level and discriminative power. We also conducted a field questionnaire survey targeting 84 staff in a hospital. Finally, we calculated ω coefficients and then used confirmatory factor analysis to verify the fit of the hypothesized model.
Our open-ended survey involving 478 nurses identified 47 codes in 9 categories. The questionnaire survey involving hospital 1000 medical staff identified 6 factors, with 1 factor subdivided into 4 subfactors and 1 into 2 subfactors. The goodness of fit of the hypothesized 10-factor models with factor pairs and groups was confirmed.
We developed a psychometric scale measuring subjective assessments of harm covering various disruptive clinician behaviors. The scale complements interviews and case reports by generating valid, reliable scores for various disruptive clinician behaviors in health care institutions.
扰乱临床医生行为会恶化沟通、信息传递和团队合作，所有这些都会对患者安全产生负面影响。改善医疗保健安全需要准确评估扰乱临床医生行为造成的损害。心理计量学量表补充了病例报告，但现有的量表有很大的局限性。因此，本研究开发了一种基于心理范式的心理计量学量表来评估扰乱临床医生的行为。
该量表是通过一系列步骤开发的。首先，我们使用了一个针对 712 名护士的开放式问卷，通过内容分析和 5 位专家的内容有效性评估，确定了用于评估扰乱临床行为的有效项目。接下来，我们针对 1000 名医护人员进行了在线问卷调查、探索性因素分析和子因素分析，以确定必要和充分的因素。然后，我们计算了难度水平和辨别力。我们还对一家医院的 84 名员工进行了现场问卷调查。最后，我们计算了 ω 系数，然后使用验证性因素分析来验证假设模型的拟合度。
我们的开放式调查涉及 478 名护士，确定了 9 个类别中的 47 个代码。涉及医院 1000 名医务人员的问卷调查确定了 6 个因素，其中 1 个因素细分为 4 个子因素，1 个因素细分为 2 个子因素。假设的 10 因素模型与因素对和组的拟合良好。
我们开发了一种心理计量学量表，用于衡量对各种扰乱临床医生行为的主观评估。该量表通过在医疗机构中为各种扰乱临床医生行为生成有效、可靠的分数，补充了访谈和病例报告。
