Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany.
Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
BMJ Open. 2024 Feb 2;14(2):e072838. doi: 10.1136/bmjopen-2023-072838.
To provide an overview of existing instruments measuring patient-perceived quality of nursing care and to develop and psychometrically evaluate a new multidimensional scale applicable to the German acute care sector.
We conducted a scale development and validation study involving the following phases: (1) performing a structured literature search to identify existing scales, (2) generating an initial pool of items using the results of the literature search and expert interviews, (3) coding/categorising the item pool, (4) organising a peer researcher workshop to select relevant items, (5) drafting the survey questionnaire and conducting cognitive pretesting, (6) pilot testing the survey questionnaire, (7) administering the survey to a large sample of hospital patients and (8) conducting a psychometric evaluation comprising exploratory factor analysis using the survey results, followed by confirmatory factor analysis and reliability and validity assessment of the resulting draft scale.
17 859 recently hospitalised patients discharged from non-intensive care in non-paediatric and non-psychiatric hospital units in Germany between May and October 2019.
We identified 32 instruments comprising 635 items on nursing care quality. Alongside 135 indicators derived from expert interviews, these formed our initial item pool, which we coded into 15 categories. From this pool, 36 items were selected in the peer researcher workshop for pretesting and psychometric evaluation. Based on the results of our exploratory and confirmatory factor analyses, we propose a second-order scale to measure Patients' Experience of Nursing Quality in Acute Hospitals (PENQuAH), including the two higher-order dimensions 'patients' perception of direct nursing care activities' and 'patients' perception of guidance provided by nurses'. The results of various tests suggest the scale has sufficient goodness of fit, reliability and validity.
The PENQuAH scale is promising in terms of its psychometric properties, the plausibility and meaningfulness of its dimensions, and its ease of use.
综述现有的测量患者感知护理质量的工具，并开发和心理计量学评估适用于德国急性护理领域的新多维量表。
我们进行了一项量表开发和验证研究，包括以下阶段：（1）进行系统文献检索以确定现有量表，（2）使用文献检索和专家访谈的结果生成初始项目池，（3）对项目池进行编码/分类，（4）组织同行研究人员研讨会以选择相关项目，（5）起草调查问卷并进行认知预测试，（6）进行试点测试，（7）对大量医院患者进行调查，以及（8）使用调查结果进行探索性因素分析，然后进行验证性因素分析和对生成的草案量表进行可靠性和有效性评估。
2019 年 5 月至 10 月期间，德国非儿科和非精神科医院普通病房出院的最近住院的 17859 名非重症患者。
我们确定了 32 种工具，包括 635 项关于护理质量的项目。除了来自专家访谈的 135 个指标外，这些工具和指标构成了我们的初始项目池，我们将其编码为 15 个类别。从这个池中，36 个项目在同行研究人员的预测试和心理计量学评估中被选中。根据我们的探索性和验证性因素分析的结果，我们提出了一个用于测量急性医院患者护理质量体验的二阶量表（PENQuAH），包括两个更高阶的维度：“患者对直接护理活动的感知”和“患者对护士提供的指导的感知”。各种测试的结果表明该量表具有足够的拟合优度、可靠性和有效性。
PENQuAH 量表在心理计量学特性、维度的合理性和有意义性以及易用性方面都很有前景。
