临床医生和护士的预先护理计划量表培训需求的心理测量测试。
Psychometric testing of the training needs for advance care planning scale for clinicians and nurses.
作者信息
He Chunju, Dong Tiaoxia, Tan Jin, Yang Liu, Qiu Yeyin, Zhang Jianghui, Huang Yi, Zhou Aiting, Wang Xianlin, Huang Yuan, Zhu Minglan, Lam Simon Ching, Deng Renli
机构信息
Department of Nursing, Affiliated Hospital of Zunyi Medical University, Guizhou Province, China.
Affiliated Hospital of Zunyi Medical University, Guizhou Province, China.
出版信息
BMC Nurs. 2024 Jul 15;23(1):476. doi: 10.1186/s12912-024-01952-7.
BACKGROUND
Studies have shown that Chinese Clinicians and nurses have positive attitudes toward ACP, but no local tools exist to assess their need for ACP knowledge and skills training. resulting in their inability to initiate ACP conversations as well as poor end-of-life care for patients. Therefore, this study aims to assess the needs of Chinese Clinicians and nurses for ACP knowledge and skills training and assess the validity and reliability of a questionnaire on the Training Needs for Advance Care Planning (TNACP) scale.
METHODS
From October to November 2021, 170 clinicians and nurses were pre-surveyed using a preliminary draft of the questionnaire. The responses were screened using item analysis, Cronbach's alpha coefficient, and the intraclass correlation coefficient (ICC) to describe the internal consistency and stability of the questionnaire. The Content validity index (CVI), Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to test the validity of the questionnaire.
RESULTS
After independent samples t-test analysis, Except for the entry "A2", the critical ratio between the two groups of the remaining 23 items was statistically significant (p < 0.05). Based on the above screening methods, the "A2" item was deleted, and the final number of questionnaire items was 23. The I-CVI was 0.79-1.00, and the S-CVI/Ave was 0.90. Three common factors were extracted-the cumulative contribution rate was 69.969%, and the factor loading of all items was 0.506-0.843 (all > 0.40). The results of confirmatory factor analysis showed that the Training Needs for Advance Care Planning (TNACP) scale model fit well(X/df = 2.504, RMSEA = 0.092, GFI = 0.809, AGFI = 0.745, CFI = 0.931, IFI = 0.932, TLI = 0.916); the Cronbach's α = 0.888 for the total questionnaire, and the three dimensions of Cronbach's α were 0.729 to 0.959; and the ICC for the overall scores between the test-retest evaluations was 0.884 (p < 0.001).
CONCLUSIONS
The TNACP scale has good reliability and validity and can be used to assess Chinese Clinicians and nurses' training needs for implementing ACP.
背景
研究表明，中国的临床医生和护士对预立医疗照护计划（ACP）持积极态度，但目前尚无本地工具来评估他们对ACP知识和技能培训的需求，导致他们无法开展ACP对话，对患者的临终关怀质量也较差。因此，本研究旨在评估中国临床医生和护士对ACP知识和技能培训的需求，并评估《预立医疗照护计划培训需求问卷》（TNACP）量表的有效性和可靠性。
方法
2021年10月至11月，使用问卷初稿对170名临床医生和护士进行了预调查。通过项目分析、克朗巴哈α系数和组内相关系数（ICC）对回答进行筛选，以描述问卷的内部一致性和稳定性。采用内容效度指数（CVI）、探索性因子分析（EFA）和验证性因子分析（CFA）来检验问卷的效度。
结果
经过独立样本t检验分析，除条目“A2”外，其余23个条目的两组临界比具有统计学意义（p < 0.05）。基于上述筛选方法，删除了“A2”条目，问卷最终条目数为23个。I-CVI为0.79 - 1.00，S-CVI/Ave为0.90。提取出三个共同因子，累积贡献率为69.969%，所有条目的因子载荷为0.506 - 0.843（均> 0.40）。验证性因子分析结果显示，预立医疗照护计划培训需求（TNACP）量表模型拟合良好（X/df = 2.504，RMSEA = 0.092，GFI = 0.809，AGFI = 0.745，CFI = 0.931，IFI = 0.932，TLI = 0.916）；问卷总量表的克朗巴哈α = 0.
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