Department of Critical Care Medicine, Hubei Clinical Research Center for Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
Department of Lung Cancer Radiotherapy and Chemotherapy, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
BMC Health Serv Res. 2024 Apr 20;24(1):491. doi: 10.1186/s12913-024-10970-9.
Hospice care professionals often experience trauma patient deaths and multiple patient deaths in a short period of time (more so than other nurses). This repeated exposure to the death process and the death of patients leads to greater psychological pressure on hospice care professionals. But at present, people pay more attention to the feelings and care burden of the family members of dying patients but pay less attention to medical staff. Thus, this study aimed to develop a scale on the burden of care for hospice care providers and assess the coping capacity of hospice professionals. Raising awareness of the psychological burden of hospice professionals.
Through a literature review, research group discussion, Delphi method and a pre-survey of professional coping skills among nurses, 200 hospice professionals who had received training in hospice care from pilot institutions engaged in or providing hospice care were selected for investigation. Cronbach's α coefficient and split-half reliability were used to test the internal consistency of the scale, and content validity and explore factor analysis (EFA) were used to test the construct validity of the scale.
Two rounds of Delphi methods were carried out, and the effective recovery rate was 100%. The expert authority coefficients of the two rounds were 0.838 and 0.833, respectively. The Kendall's W coefficient of experts in the first round was 0.121 ~ 0.200 (P < 0.05), and the Kendall's W coefficient of the second round was 0.115-0.136 (P < 0.05), indicating a good level of expert coordination. The final survey scale for the care burden of hospice professionals included four dimensions-working environment (9 items), professional roles (8 items), clinical nursing (9 items) and psychological burden (7 items)-with a total of 33 items. The total Cronbach's α coefficient of the scale was 0.963, and the Cronbach's α coefficients of the working environment, professional roles, clinical nursing and psychological burden dimensions were 0.920, 0.889, 0.936 and 0.910, respectively. The total split-half reliability of the scale was 0.927, and the split-half reliability of each dimension was 0.846, 0.817, 0.891, and 0.832. The content validity of the scale items ranged from 0.90 to 1.00. Exploratory factor analysis revealed 5 common factors, with a total cumulative contribution rate of 68.878%. The common degree of each item in the scale was > 0.4, and the factor loading of each item was also > 0.4.
The scale is an open-access, short, easy-to-administer scale. And which for assessing hospice care burden among hospice professionals developed in this study demonstrated strong reliability and validity. This tool can serve as a dependable instrument for evaluating the burden of hospice care for terminally ill patients by professionals in the hospice setting.
临终关怀专业人员经常在短时间内经历创伤患者死亡和多名患者死亡（比其他护士更多）。这种反复接触死亡过程和患者死亡会给临终关怀专业人员带来更大的心理压力。但目前，人们更多地关注临终患者家属的感受和护理负担，而较少关注医务人员。因此，本研究旨在开发一种临终关怀提供者护理负担量表，并评估临终关怀专业人员的应对能力。提高对临终关怀专业人员心理负担的认识。
通过文献回顾、研究小组讨论、德尔菲法和对试点机构从事或提供临终关怀的护士专业应对技能的预调查，选择 200 名接受过临终关怀培训的临终关怀专业人员进行调查。采用克朗巴赫α系数和分半信度检验量表的内部一致性，采用内容效度和探索性因素分析（EFA）检验量表的结构效度。
进行了两轮德尔菲法，有效回收率为 100%。两轮专家权威系数分别为 0.838 和 0.833。第一轮专家 Kendall's W 系数为 0.1210.200（P<0.05），第二轮专家 Kendall's W 系数为 0.115-0.136（P<0.05），表明专家协调性较好。临终关怀专业人员护理负担最终调查量表包括工作环境（9 项）、专业角色（8 项）、临床护理（9 项）和心理负担（7 项）四个维度，共 33 项。量表的总克朗巴赫α系数为 0.963，工作环境、专业角色、临床护理和心理负担维度的克朗巴赫α系数分别为 0.920、0.889、0.936 和 0.910。量表的总半分信度为 0.927，各维度的半分信度分别为 0.846、0.817、0.891 和 0.832。量表项目的内容效度为 0.901.00。探索性因素分析显示有 5 个公因子，累计贡献率为 68.878%。量表各项目的共性度均>0.4，各项目的因子负荷也均>0.4。
该量表是一种开放获取、简短、易于管理的量表。本研究开发的用于评估临终关怀专业人员临终关怀负担的量表具有较强的信度和效度。该工具可作为评估临终关怀机构中专业人员对终末期患者护理负担的可靠工具。
