Nettelrodt Karolin M E, Tomsic Ivonne, Stolz Maike, Krauth Christian, Chaberny Iris F, von Lengerke Thomas
Department of Medical Psychology, Center of Public Health, Hannover Medical School, Hannover, Germany.
Institute of Epidemiology, Social Medicine and Health Systems Research, Center of Public Health, Hannover Medical School, Hannover, Germany.
Psychol Res Behav Manag. 2024 Jul 23;17:2757-2767. doi: 10.2147/PRBM.S464335. eCollection 2024.
Psychosocial determinants influence healthcare workers' compliance with surgical site infection (SSI) preventive interventions. In order to design needs-based interventions promoting compliance, such determinants must first be assessed using valid and reliable questionnaire scales. To compare professional groups without bias, the scales must also be measurement-equivalent. We examine the validity/reliability and measurement equivalence of four scales using data from physicians and nurses from outside the university sector. Additionally, we explore associations with self-reported SSI preventive compliance.
N = 90 physicians and N = 193 nurses (response rate: 31.5%) from nine general/visceral or orthopedic/trauma surgery departments in six non-university hospitals in Germany participated. A written questionnaire was used to assess the compliance with SSI preventive interventions and the determinants of compliance based on the Capability-Opportunity-Motivation-Behavior-Model. Psychometric testing involved single- and multiple-group confirmatory factor analyses, and explorative analyses used -tests and multiple linear regression.
The scales assessing individual determinants of compliance (capability, motivation, and planning) were found to be reliable (each Cronbach's α ≥ 0.85) and valid (each Root-Mean-Square-Error of Approximation ≤ 0.065, each Comparative-Fit-Index = 0.95) and revealed measurement equivalence for physicians and nurses. The scale assessing external determinants (opportunity) did not demonstrate validity, reliability, or measurement equivalence. Group differences were found neither in compliance (p = 0.627) nor determinants (p = 0.192; p = 0.866; p = 0.964). Capability (β = 0.301) and planning (β = 0.201) showed associations with compliance for nurses only.
The scales assessing motivation, capability, and planning regarding SSI preventive compliance provided reliable and valid scores for physicians and nurses in surgery. Measurement equivalence allows group comparisons of scale means to be interpreted without bias.
社会心理决定因素会影响医护人员对手术部位感染（SSI）预防干预措施的依从性。为了设计基于需求的促进依从性的干预措施，必须首先使用有效且可靠的问卷量表对这些决定因素进行评估。为了无偏差地比较不同专业群体，这些量表还必须具有测量等效性。我们使用来自大学以外部门的医生和护士的数据，检验了四个量表的效度/信度和测量等效性。此外，我们还探讨了与自我报告的SSI预防依从性之间的关联。
来自德国六家非大学医院的九个普通/内脏或骨科/创伤外科科室的90名医生和193名护士（回复率：31.5%）参与了研究。使用书面问卷评估对SSI预防干预措施的依从性以及基于能力-机会-动机-行为模型的依从性决定因素。心理测量测试包括单组和多组验证性因素分析，探索性分析使用t检验和多元线性回归。
评估依从性个体决定因素（能力、动机和计划）的量表被发现是可靠的（每个Cronbach's α≥0.85）且有效的（每个近似均方根误差≤0.065，每个比较拟合指数 = 0.95），并且显示出医生和护士之间的测量等效性。评估外部决定因素（机会）的量表未显示出效度、信度或测量等效性。在依从性（p = 0.627）或决定因素方面（p = 0.192；p = 0.866；p = 0.964）均未发现组间差异。能力（β = 0.301）和计划（β = 0.201）仅与护士的依从性相关。
评估SSI预防依从性的动机、能力和计划的量表为外科医生和护士提供了可靠且有效的分数。测量等效性使得量表均值的组间比较能够无偏差地进行解释。
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